Serratia marcescens Peritonitis in a Diabetic Patient Receiving Continuous Ambulatory Peritoneal Dialysis

Area of Science:

• Nephrology
• Infectious Diseases
• Microbiology

Background:

• Peritonitis is a serious complication for patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
• Diabetes mellitus is a known risk factor for infections in CAPD patients.
• Serratia marcescens is an opportunistic pathogen that can cause peritonitis.

Purpose of the Study:

• To report an unusual case of Serratia marcescens peritonitis in a CAPD patient.
• To highlight the challenges in treating S. marcescens peritonitis in this population.
• To emphasize the importance of considering catheter removal in refractory cases.

Main Methods:

• Case presentation of a 45-year-old male with insulin-dependent diabetes mellitus on CAPD.
• Clinical presentation included abdominal pain and cloudy dialysate.
• Empirical and targeted antibiotic therapy (cefazolin, ceftazidime, gentamicin, ciprofloxacin) was administered.
• Dialysate analysis and white blood cell (WBC) count monitoring.
• Surgical intervention involving CAPD catheter removal.

Main Results:

• Serratia marcescens was identified as the causative agent of peritonitis.
• Initial intraperitoneal and oral antibiotic therapy did not resolve the infection.
• Persistent abdominal pain and elevated dialysate WBC count were observed.
• Removal of the CAPD catheter was ultimately required to manage the peritonitis.

Conclusions:

• Serratia marcescens peritonitis can be challenging to treat in CAPD patients, even with appropriate antibiotics.
• Catheter removal may be necessary for refractory cases of S. marcescens peritonitis.
• This case underscores the importance of vigilant monitoring and prompt intervention in CAPD-related infections.