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A Case of Refractory Peritoneal Dialysis-Related Peritonitis Caused by Streptococcus gordonii
Kenta Torigoe1, Yoshie Yamashita1, Ayuko Yamashita1
1Department of Nephrology, Nagasaki University Hospital, Nagasaki, JPN.
Abstract:
An 82-year-old woman undergoing peritoneal dialysis (PD) presented to our hospital with cloudy PD effluent since four days. The leukocyte count in the effluent was elevated to 2900/μL, and the patient was diagnosed with PD-related peritonitis. Treatment with cefazolin and ceftazidime was initiated; however, the leukocyte count in the effluent did not improve. Culture of the effluent revealed the presence of Streptococcus gordonii. Treatment was switched to ampicillin monotherapy; however, when the leukocyte count in the effluent still did not normalize, the PD catheter was removed for management of refractory PD-related peritonitis, which was then cured. S. gordonii can form biofilms, suggesting that PD-related peritonitis may develop through the formation of biofilms on the catheter, leading to refractory peritonitis.
Insights
Peritonitis in peritoneal dialysis (PD) patients can be challenging to treat. This case highlights Streptococcus gordonii biofilm formation on PD catheters causing refractory peritonitis, necessitating catheter removal for cure.
Area of Science:
- Nephrology
- Infectious Diseases
- Microbiology
Background:
- Peritoneal dialysis (PD) is a common treatment for end-stage renal disease.
- PD-related peritonitis is a serious complication that can lead to treatment failure.
- Refractory peritonitis cases require careful investigation into causative agents and mechanisms.
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