Pseudomyxoma peritonei as a cause of culture-negative peritonitis for a patient undergoing peritoneal dialysis

Area of Science:

• Nephrology
• Infectious Diseases
• Gastroenterology

Background:

• Culture-negative peritonitis is a significant complication of peritoneal dialysis (PD), accounting for up to 20% of cases.
• Potential causes include technical errors, prior antibiotic use, fastidious organisms, visceral inflammation, and malignancy.

Observation:

• A patient with end-stage renal disease undergoing PD presented with culture-negative peritonitis and ultrafiltration failure.
• The underlying cause was identified as pseudomyxoma peritonei, a rare intra-abdominal malignancy.

Findings:

• This case demonstrates pseudomyxoma peritonei as a rare etiology of culture-negative peritonitis and ultrafiltration failure in PD patients.
• Diagnosis was challenging due to the absence of positive microbial cultures.

Implications:

• Early and comprehensive imaging studies are crucial for diagnosing culture-negative peritonitis, especially when suspecting visceral inflammation or malignancy.
• Recognizing rare causes like pseudomyxoma peritonei can guide timely and appropriate management in PD patients.