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Mycobacterium septicum associated peritonitis: A case report
Nattawat Klomjit1, Api Chewcharat1, Margaret D'Uscio1
1Division of Nephrology and Hypertension, 4352Mayo Clinic, Rochester, MN, USA.
Summary
Peritonitis from Mycobacterium septicum is rare in peritoneal dialysis (PD) patients. This case shows successful treatment with antibiotics and catheter removal, highlighting challenges in managing nontuberculous mycobacterial infections.
Area of Science:
- Nephrology
- Infectious Diseases
- Microbiology
Background:
- Peritoneal dialysis (PD) is a crucial treatment for end-stage kidney disease.
- PD-associated peritonitis, while uncommon with mycobacteria, presents significant treatment challenges and poor outcomes.
- Nontuberculous mycobacteria (NTM) represent a growing list of causative agents for PD peritonitis.
Observation:
- A 53-year-old male on PD for end-stage kidney disease secondary to systemic sclerosis presented with abdominal pain and elevated inflammatory markers in PD effluent.
- Dialysate culture subsequently identified Mycobacterium septicum, a rapidly growing NTM.
Findings:
- The patient received a tailored antibiotic regimen including moxifloxacin and doxycycline after PD catheter removal.
- Treatment resulted in decreasing cell counts and negative PD fluid cultures.
- The patient completed 4 months of antibiotic therapy with a favorable outcome.
Implications:
- This case underscores the importance of considering NTM in PD peritonitis, even rare species like M. septicum.
- Early identification and appropriate antimicrobial therapy, alongside catheter management, are critical for successful treatment.
- Managing NTM peritonitis in PD patients requires a complex, individualized approach due to potential treatment challenges and variable outcomes.
