Mycobacterium gastri peritonitis in a patient undergoing continuous ambulatory peritoneal dialysis

This report documents a case of peritonitis due to Mycobacterium gastri in a 28 year old woman on continuous ambulatory peritoneal dialysis. She presented with persistent abdominal pain and clear peritoneal drainage fluid which contained increased numbers of lymphocytes. The diagnosis was made by identification of acid-fast bacilli in peritoneal fluid and within a peritoneal biopsy specimen, and culture of Mycobacterium gastri from peritoneal fluid. Treatment with rifampicin and ethambutol and removal of the Tenckhoff catheter has proved effective. The case highlights the importance of searching for slow growing organisms in apparently 'aseptic' peritonitis in peritoneal dialysis patients.