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Rare Pathogens in Peritoneal Dialysis-Associated Peritonitis: A Comprehensive Case Study and Guideline Review
Abbas Mohammadi1, Hossein Akhondi1, Dhiresh R Joshi2
1Department of Internal Medicine, Spring Valley Hospital, Valley Health System, Las Vegas, NV, USA.
The American Journal of Case Reports
|June 4, 2024
Summary
Peritoneal dialysis (PD) peritonitis can be caused by rare bacteria like Achromobacter and carbapenem-resistant Acinetobacter. Patient education and catheter removal were key to resolving infection in this ESRD case.
Area of Science:
- Nephrology
- Infectious Diseases
- Critical Care Medicine
Background:
- Peritoneal dialysis (PD) is a vital renal replacement therapy for end-stage renal disease (ESRD).
- Peritonitis is a significant complication of PD, impacting patient outcomes.
- Managing PD-associated infections requires understanding common and rare causative agents.
Observation:
- An 80-year-old female with ESRD on PD experienced two peritonitis episodes within 8 months.
- The infections were caused by unusual pathogens: Achromobacter denitrificans/xylosoxidans and Carbapenem-resistant Acinetobacter baumannii.
- Symptoms included abdominal pain and turbid dialysis fluid, common in peritonitis.
Findings:
- This case highlights rare bacterial causes of PD peritonitis.
- Targeted antibiotic therapy based on susceptibility testing was crucial.
- Removal of the PD catheter and transition to hemodialysis led to infection resolution.
Implications:
- Emphasizes the need for rigorous infection control in PD settings.
- Underscores considering atypical and resistant pathogens in PD peritonitis.
- Highlights the importance of patient education and involvement in treatment decisions for complex PD infections.
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