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Peritoneal Dialysis-Related Mycobacterium fortuitum Exit-Site/Tunnel Infection in a Pediatric Patient: A Case Report
Rina Takahashi1, Hiroshi Tamura1, Keishiro Furuie1
1Department of Pediatrics, Faculty of Life Sciences Kumamoto University Kumamoto Japan.
Abstract:
In patients in peritoneal dialysis (PD) who develop exit site and/or catheter tunnel infections, expeditious identification of the causative organism and early implementation of treatment are important to ensure good outcomes. Among the many causative organisms, the diagnosis of Mycobacterium fortuitum is particularly challenging, with its treatment often requiring a combination of approaches, including the removal of the peritoneal catheter and the administration of multiple antibiotics. Here, we present the case of a 25-month-old pediatric patient on PD who developed PD-associated tunnel infection due to M. fortuitum; the patient was successfully treated with multimodal antibiotics, with no sequela, following the rapid identification of the causative agent, the use of multimodal antibiotics, and PD catheter removal. In our case, the timely initiation of treatment, combined with ultrasound evaluation, was crucial for achieving a favorable outcome.
Insights
Rapid diagnosis and multimodal treatment, including catheter removal, are key for successfully managing Mycobacterium fortuitum tunnel infections in pediatric peritoneal dialysis patients. This approach ensured a favorable outcome with no lasting complications.
Area of Science:
- Infectious Diseases
- Nephrology
- Pediatrics
Background:
- Peritoneal dialysis (PD) patients are susceptible to exit site and catheter tunnel infections.
- Mycobacterium fortuitum infections in PD patients present diagnostic and therapeutic challenges.
- Treatment often necessitates catheter removal and combination antibiotic therapy.
Purpose of the Study:
- To report a successful management strategy for a pediatric PD patient with Mycobacterium fortuitum tunnel infection.
- To highlight the importance of rapid diagnosis and multimodal treatment in achieving favorable outcomes.
Main Methods:
- Case report of a 25-month-old pediatric patient on PD.
- Infectious agent identified as Mycobacterium fortuitum.
- Treatment involved multimodal antibiotics and PD catheter removal.
- Ultrasound evaluation was utilized.
Main Results:
- Successful treatment of Mycobacterium fortuitum tunnel infection.
- No sequelae observed in the patient post-treatment.
- Rapid identification and timely intervention were critical.
Conclusions:
- Multimodal antibiotic therapy combined with PD catheter removal can effectively treat Mycobacterium fortuitum tunnel infections in pediatric patients.
- Prompt diagnosis and intervention, aided by imaging, are crucial for positive outcomes in PD-related infections.
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