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Encapsulating peritoneal sclerosis in a peritoneal dialysis patient presenting with complicated Mycobacterium

Mohammed Amin Simbli1, Faraz A Niaz, Jamal S Al-Wakeel

  • 1Division of Nephrology, Department of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. mohdamin1126@yahoo.com

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|May 10, 2012
PubMed

Insights

Encapsulating peritoneal sclerosis (EPS), a serious complication of long-term dialysis, was diagnosed in a patient with culture-negative peritonitis. Specific cultures revealed Mycobacterium fortuitum (MF) as the causative agent, confirmed by radiological findings of EPS.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Radiology

Background:

  • Encapsulating peritoneal sclerosis (EPS) is a rare, severe complication in patients on long-term peritoneal dialysis (PD), presenting with non-specific symptoms.
  • High-concentration dialysis fluids and prolonged dialysis duration are risk factors for EPS.
  • Mycobacterium fortuitum (MF) is an uncommon pathogen causing peritonitis in PD patients.

Observation:

  • A patient undergoing continuous ambulatory peritoneal dialysis (CAPD) presented with symptoms suggestive of peritonitis but initial cultures were negative.
  • Subsequent specific cultures identified Mycobacterium fortuitum (MF) as the cause of peritonitis.
  • Radiological evaluation revealed characteristic features of Encapsulating peritoneal sclerosis (EPS).

Findings:

  • This case highlights MF as a potential cause of culture-negative peritonitis in CAPD patients.
  • The diagnosis of EPS was confirmed in conjunction with MF peritonitis.
  • Early suspicion and specific microbiological and radiological investigations are crucial.

Implications:

  • This case broadens the understanding of infectious causes of EPS in PD patients.
  • It emphasizes the importance of considering atypical pathogens like MF in refractory peritonitis.
  • Prompt diagnosis and treatment may improve outcomes for PD patients with EPS and MF infection.

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