Campylobacter fetus Peritonitis in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis

Peritonitis is one of the most serious complications of peritoneal dialysis (PD). The most common microbial causes of PD-associated peritonitis are Gram-positive pathogens. However, unusual microorganisms may be involved in this type of infection, such as Campylobacter fetus. Here, we report a case of C. fetus peritonitis in a 60-year-old woman undergoing continuous ambulatory PD. This patient was admitted to the nephrology department with a history of fatigue, abdominal pain, diarrhea, vomiting, and fever. A bacteriological examination of the PD effluent revealed a cloudy liquid containing 900 leukocytes/mm3 with 75% polymorphonuclear neutrophils. C. fetus was obtained in a pure culture. Antibiotic susceptibility testing was performed. A favorable outcome was noted after treatment with amoxicillin or clavulanic acid and amikacin. Thus, an accurate bacteriological diagnosis of PD-associated peritonitis requires optimal culture methods to improve the isolation of fastidious microorganisms such as Campylobacter and therefore guide appropriate antibiotic therapy.