Mycobacterium avium complex-associated peritonitis with CAPD after unrelated bone marrow transplantation

Area of Science:

• Nephrology
• Infectious Diseases
• Hematology

Background:

• Peritonitis is a significant complication of peritoneal dialysis, typically caused by enteric bacteria.
• Non-tuberculous mycobacteria (NTM) peritonitis is an uncommon but severe infection requiring specialized diagnostic methods.
• Prompt identification of NTM is essential to prevent treatment delays.

Observation:

• A case of an 11-year-old girl with aplastic anemia undergoing peritoneal dialysis is presented.
• The patient developed Mycobacterium avium complex (MAC)-associated peritonitis post-allogeneic hematopoietic stem cell transplantation (allo-HSCT).
• This occurred despite standard cultures being negative and empirical antibiotic treatment being ineffective.

Findings:

• Mycobacterium avium complex peritonitis can occur in immunocompromised patients after allo-HSCT.
• NTM infections necessitate specific culture techniques for accurate and timely diagnosis.
• Refractory infections with negative standard cultures should raise suspicion for NTM.

Implications:

• Increased vigilance for NTM infections is critical in allo-HSCT recipients.
• Specialized cultures are vital for diagnosing NTM peritonitis, especially in refractory cases.
• This case highlights the importance of considering NTM in the differential diagnosis of peritonitis in this patient population.