Chryseobacterium indologenes peritonitis in a peritoneal dialysis patient

Peritonitis remains an important complication of peritoneal dialysis. The Gram-negative bacillus Chryseobacterium indologenes causes infection mostly in immunocompromised patients with severe underlying disease, mainly in Asia. Herein, we report the first case in Europe and the second case in an immunocompetent patient of peritoneal dialysis-associated C. indologenes peritonitis. Our patient presented with abdominal pain and a cloudy effluent and was started on intraperitoneal antibiotics. The organism cultured from the peritoneal fluid was later identified as C. indologenes and antibiotic therapy was adjusted accordingly. Despite this, the peritonitis followed a relapsing course, requiring Tenckhoff catheter removal, temporary transfer to haemodialysis and intravenous antibiotics. Subsequently, a new Tenckhoff catheter was inserted and peritoneal dialysis was restarted. The patient remains peritonitis free after 18 months of follow-up. This case highlights the need to consider rare causes of peritonitis in peritoneal dialysis patients as well as the heterogeneous clinical course of C. indologenes peritonitis.