Response of Weeksella virosa peritonitis to imipenem/cilastin

CAPD peritonitis is most commonly due to gram positive infection. Gram negative bacillary infection is less frequent but is often seen in hospitalized patients or in those on antibiotics. Weeksella virosa (formerly known as Flavobacterium II F) has been isolated from the vaginal secretions and urine of normal women. As gram negative colonization typically proceeds from the perineal region, Weeksella virosa peritonitis might be expected in women at risk for gram negative peritonitis. A 33-year-old woman on CAPD developed multiply resistant Weeksella virosa peritonitis after prior hospitalization for pericarditis and antibiotic treatment for pneumonia. Cultures became negative and cell counts returned to normal during treatment with intravenous imipenem/cilastin. Curative treatment was completed with intraperitoneal imipenem/cilastin and oral ampicillin. Treatment was well tolerated despite theoretical concerns about the risk of seizures in patients with severe renal insufficiency not on hemodialysis.