Actinomyces odontolyticus: A Rare Agent of Exit-Site Infection in Peritoneal Dialysis

Exit-site infections (ESIs) of peritoneal dialysis catheters can cause serious complications if not promptly treated. Uncommon pathogens like Actinomyces odontolyticus are infrequently associated with these infections. We report a 26-year-old woman with end-stage renal disease due to Alport syndrome, presenting with recurrent purulent discharge and erythema at the Tenckhoff catheter exit site. Initial cultures were negative, and empirical treatment with cotrimoxazole was provided with an apparent resolution of the infection. Upon recurrence, A. odontolyticus was identified in an anaerobic culture, showing resistance to multiple antibiotics, including penicillin. Treatment with doxycycline resolved the infection within four weeks without requiring catheter removal. No recurrence was observed after six months. This case highlights the importance of early diagnosis and tailored antibiotic therapy in managing rare infections. It emphasizes the need for collaboration with microbiology labs to ensure proper identification of atypical pathogens. Early intervention and targeted treatment can lead to excellent outcomes, potentially avoiding catheter removal.