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Rare Pathogens in Peritoneal Dialysis-Associated Peritonitis: A Comprehensive Case Study and Guideline Review

Abbas Mohammadi, Hossein Akhondi, Dhiresh R. Joshi, S. Mirabbasi

The American journal of case reports, 2024

4 citations

Abstract

Patient: Female, 80-year-old Final Diagnosis: Non-repeat peritoneal dialysis–associated peritonitis • peritonitis Symptoms: Mild abdominal discomfort • peritonitis Clinical Procedure: Antibiotics • dialysis Specialty: Infectious Diseases • General and Internal Medicine • Nephrology Objective: Rare disease Background: Peritoneal dialysis (PD) serves as a critical renal replacement therapy for individuals with end-stage renal disease (ESRD), leveraging the peritoneum for fluid and substance exchange. Despite its effectiveness, PD is marred by complications such as peritonitis, which significantly impacts patient outcomes. The novelty of our report lies in the presentation of a rare case of PD-associated peritonitis caused by 2 unusual pathogens, emphasizing the importance of rigorous infection control measures. Case Report: We report on an 80-year-old African-American female patient with ESRD undergoing PD, who was admitted twice within 8 months for non-recurring episodes of peritonitis. These episodes were attributed to the rare pathogens Achromobacter denitrificans/xylosoxidans and Carbapenem-resistant Acinetobacter baumannii. Despite presenting with similar symptoms during each episode, such as abdominal pain and turbid dialysis effluent, the presence of these uncommon bacteria highlights the intricate challenges in managing infections associated with PD. The treatment strategy encompassed targeted antibiotic therapy, determined through susceptibility testing. Notably, the…

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