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Streptococcus viridans-associated peritonitis after gastroscopy.

Eduardo Machuca1, Ana M Ortiz, Ricardo Rabagliati

  • 1Department of Nephrology, P. Catholic University, Santiago, Chile. eamachuc@puc.cl

Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis
|May 12, 2006
PubMed
Summary

Peritonitis can occur after gastroscopy in peritoneal dialysis patients, even without direct contamination. Streptococcus viridans peritonitis developed in a patient post-procedure, highlighting the need for antibiotic prophylaxis.

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Area of Science:

  • Nephrology
  • Infectious Diseases

Background:

  • Transient bacteremia is common after endoscopic procedures.
  • Streptococcus viridans peritonitis is linked to peritoneal dialysis, often from oral flora.
  • No prior reports linked gastroscopy to peritonitis in peritoneal dialysis patients.

Observation:

  • A 69-year-old male on automated peritoneal dialysis underwent emergency gastroscopy for a duodenal ulcer.
  • The day after the procedure, he presented with nausea and abdominal pain.
  • Peritoneal fluid analysis revealed cloudy effluent with elevated neutrophils, confirming peritonitis.

Findings:

  • Peritoneal fluid culture identified Streptococcus viridans.
  • The patient was successfully treated with ceftazidime and clarithromycin.

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  • This case represents the first report of peritonitis after gastroscopy in a peritoneal dialysis patient.
  • Implications:

    • Esophagogastroduodenal endoscopy poses a risk of peritonitis for peritoneal dialysis patients.
    • Antibiotic prophylaxis should be considered for peritoneal dialysis patients undergoing these procedures.
    • This underscores the importance of vigilance for infection following endoscopic interventions in this vulnerable population.