Stenotrophomonas maltophilia peritonitis in a patient receiving automated peritoneal dialysis

Area of Science:

• Infectious Diseases
• Nephrology
• Microbiology

Background:

• Nosocomial infections caused by Stenotrophomonas maltophilia are a growing concern.
• Peritonitis is a rare but serious complication for patients on chronic peritoneal dialysis.
• End-stage renal disease necessitates renal replacement therapy, such as peritoneal dialysis.

Observation:

• A 54-year-old female on automated peritoneal dialysis presented with fever, abdominal pain, and cloudy effluent.
• No prior history of peritonitis or catheter exit-site infection was noted.
• Stenotrophomonas maltophilia was identified as the causative agent in the peritoneal effluent.

Findings:

• The patient was treated with a combination of trimethoprim/sulfamethoxazole for six weeks and amikacin for 14 days.
• Complete recovery was achieved without the need for peritoneal dialysis catheter removal.
• No recurrence of S. maltophilia peritonitis was observed during follow-up.

Implications:

• This case highlights the successful management of Stenotrophomonas maltophilia peritonitis in a peritoneal dialysis patient.
• Antibiotic therapy alone can be effective, potentially avoiding catheter removal in select cases.
• Early recognition and appropriate antimicrobial treatment are crucial for favorable outcomes in S. maltophilia peritonitis.