Mycobacterium phlei peritonitis: a rare complication of chronic peritoneal dialysis

We report the first case of chronic ambulatory peritoneal dialysis-associated peritonitis caused by Mycobacterium phlei. This organism was isolated from the peritoneal fluid of a patient who presented with recurrent episodes of "culture-negative" peritonitis. The therapeutic regimen was based on previous experience with other rapidly growing atypical mycobacteria, and included removal of the Tenckhoff catheter, institution of hemodialysis, and anti-mycobacterial therapy with amikacin, cefoxitin, and doxycycline. This successfully eradicated the organism, and permitted subsequent cadaveric renal transplantation with routine immunosuppression.