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[Recurring peritonitis due to Streptococcus from the upper respiratory tract in a saxophone player under peritoneal

Mustapha Amirou1, Dominique Lombart, Kedna Thomas

  • 1Service de néphrologie-hémodialyse, Hôpital de Rodez.

Annales De Biologie Clinique
|April 10, 2012
PubMed

Insights

A saxophonist on peritoneal dialysis experienced recurrent peritonitis from oral streptococci. Playing the saxophone increased intra-abdominal pressure, likely causing self-contamination and infection.

Area of Science:

  • Medical Science
  • Infectious Diseases
  • Nephrology

Background:

  • A 77-year-old male on peritoneal dialysis with comorbidities (diabetes, hypertension, coronary disease) developed recurrent peritonitis.
  • The patient is a professional saxophonist.

Observation:

  • Two episodes of peritonitis occurred within months, caused by Streptococcus mitis/oralis and Streptococcus parasanguis.
  • Both episodes followed the patient playing the saxophone.
  • Colonoscopy revealed a sigmoid polyp.
  • Playing the saxophone increased intra-peritoneal pressure (IPP) significantly (8-32 cm H2O) and aerosolized saliva.

Findings:

  • The oral streptococci identified are common in the mouth.
  • The findings suggest a link between saxophone playing, increased IPP, saliva aerosolization, and subsequent peritonitis.
  • This indicates a potential self-contamination route in peritoneal dialysis patients who are musicians.

Implications:

  • Patients undergoing peritoneal dialysis should be aware of potential risks associated with certain activities.
  • This case highlights the importance of considering unusual self-contamination pathways in recurrent infections.
  • Preventive measures, such as refraining from playing wind instruments, may be necessary for some patients.

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