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Summary
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A rare case of eosinophilic peritonitis (EP) occurred in a patient undergoing peritoneal dialysis. Vancomycin treatment for bacterial peritonitis likely triggered the EP, which resolved after vancomycin discontinuation.

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Pathology

Background:

  • Peritoneal dialysis (PD) is a crucial treatment for end-stage renal disease.
  • Bacterial peritonitis is a common complication of PD.
  • Eosinophilic peritonitis (EP) is a rare but serious condition.

Observation:

  • A patient on PD developed symptoms consistent with bacterial peritonitis.
  • Vancomycin was administered intraperitoneally to treat the suspected bacterial infection.
  • The patient's condition worsened, showing severe hypotension and cardiovascular compromise.

Findings:

  • The patient was diagnosed with eosinophilic peritonitis (EP), not bacterial peritonitis.
  • Intraperitoneal vancomycin was identified as the probable cause of EP.
  • Discontinuation of vancomycin led to the resolution of EP and cardiovascular symptoms.

Implications:

  • This case highlights a rare adverse reaction to vancomycin in PD patients.
  • Clinicians should consider vancomycin-induced EP in patients with refractory peritonitis.
  • Early recognition and vancomycin withdrawal are crucial for managing this condition.