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Peritoneal dialysis-related Listeria monocytogenes peritonitis treated with both intravenous and intraperitoneal

Scott MacKay1, Benjamin W Ewanchuk1, Mark McIsaac2

  • 1University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada.

BMJ Case Reports
|October 16, 2024
PubMed

Listeria monocytogenes is a ubiquitous bacterium and opportunistic pathogen for immunocompromised patients. Peritoneal dialysis-related L. monocytogenes peritonitis is a rare clinical presentation, with a total of 23 cases reported to date and an overall mortality rate of 17.3%. The current report describes a case of peritoneal dialysis-related L. monocytogenes peritonitis in a woman in her 60s on long-term immunosuppressive therapies for a prior renal transplant. We treated this patient successfully with intraperitoneal ampicillin (125 mg/L in dialysate), in addition to intravenous ampicillin (1 g every 12 hours) for 10 days and subsequent oral amoxicillin 500 mg every 12 hours to complete a total 21-day course of therapy. This treatment regimen was informed by a literature review of pre-existing case studies, which demonstrated considerable variability in recommended antimicrobial dosing and frequency. A summary of this literature review is included in the current case report.

Keywords:
DialysisRenal medicine

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