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Citrobacter freundii peritonitis and tunnel infection in a patient on continuous ambulatory peritoneal dialysis

Erkan Dervisoglu1, Zeki Yumuk2, Itir Yegenaga1

  • 1Department of Internal Medicine, Division of Nephrology, School of Medicine, Kocaeli University, Kocaeli 41380, Turkey.

Journal of Medical Microbiology
|December 11, 2007
PubMed

Insights

A patient on peritoneal dialysis experienced peritonitis and tunnel infection from Citrobacter freundii. Standard antibiotic treatment failed, necessitating catheter removal.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Medical Microbiology

Background:

  • Continuous ambulatory peritoneal dialysis (CAPD) is a common renal replacement therapy.
  • Peritonitis and tunnel infections are known complications of CAPD.
  • Prompt diagnosis and effective treatment are crucial for managing CAPD-related infections.

Observation:

  • A case of CAPD-associated peritonitis and tunnel infection caused by Citrobacter freundii is presented.
  • Citrobacter freundii is an uncommon pathogen in CAPD infections.
  • The patient's clinical course involved persistent infection despite appropriate antimicrobial therapy.

Findings:

  • The patient received intravenous meropenem and intraperitoneal gentamicin based on antibiogram results.
  • Therapeutic response to the prescribed antibiotics was inadequate.
  • Surgical intervention, including catheter removal, was ultimately required to resolve the infection.

Implications:

  • This case highlights the potential for unusual pathogens like Citrobacter freundii to cause severe CAPD infections.
  • It underscores the importance of considering treatment failure and the need for alternative strategies, including catheter removal, in refractory cases.
  • Further research may be warranted to understand the specific virulence factors and optimal management of Citrobacter freundii infections in CAPD patients.

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