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A Case of Peritoneal Dialysis-Related Peritonitis Due to Moraxella osloensis
Kenta Torigoe1, Ai Yoshidome1, Emiko Otsuka1
1Department of Nephrology, Nagasaki University Hospital, Nagasaki, JPN.
Abstract:
A 46-year-old woman on peritoneal dialysis (PD) had cloudy peritoneal dialysis effluent that had persisted for 10 days by the time she visited our hospital. The white blood cell count in the effluent was elevated to 1500/μL, leading to a diagnosis of peritoneal dialysis-associated peritonitis. The effluent cleared within two days with treatment using cefazolin and ceftazidime, and the white blood cell count dropped to 0/μL by day 6. Culture of the effluent revealed the presence of Moraxella osloensis. The patient's treatment was switched to ceftazidime monotherapy, and antibiotic therapy for 21 days resulted in the resolution of the peritonitis. Reports of peritonitis caused by Moraxella osloensis are rare; however, with the spread of diagnostic methods, such as matrix-assisted laser desorption ionization-time of flight mass spectrometry, an increase in reported cases is expected. Unlike previous cases, in this case, the interval from onset to treatment initiation was longer. However, similar to reported cases, in this case, the infection was cured with antibiotic treatment without the need for PD catheter removal.
Insights
Peritonitis in patients on peritoneal dialysis (PD) caused by Moraxella osloensis is rare. This case highlights successful antibiotic treatment without PD catheter removal, even with a delayed diagnosis.
Area of Science:
- Nephrology
- Infectious Diseases
- Microbiology
Background:
- Peritonitis is a serious complication of peritoneal dialysis (PD).
- Early diagnosis and treatment are crucial for successful management and preventing PD catheter removal.
- Moraxella osloensis is an uncommon cause of PD-associated peritonitis.
Observation:
- A 46-year-old woman on PD presented with persistent cloudy effluent and elevated white blood cell count, indicative of peritonitis.
- Effluent culture identified Moraxella osloensis as the causative pathogen.
- Despite a 10-day delay in treatment initiation, the patient's condition improved with antibiotics.
Findings:
- Initial treatment with cefazolin and ceftazidime led to rapid clinical improvement.
- Moraxella osloensis peritonitis was successfully treated with a 21-day course of ceftazidime monotherapy.
- The patient's PD catheter was preserved, and peritonitis resolved completely.
Implications:
- This case expands the understanding of Moraxella osloensis as a cause of PD peritonitis.
- Advanced diagnostic techniques may lead to increased identification of rare pathogens like Moraxella osloensis.
- Successful antibiotic management without catheter removal is achievable even in cases with delayed presentation.
