Chang Celeste Sharon, Chen Han-Hsiang, Liu Hsiang-Chung, Wu Chih-Jen
Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
South Med J. 2011 May;104(5):373-4. doi: 10.1097/SMJ.0b013e31820dc1f8.
We present two cases of peritoneal dialysis (PD) catheter-related Pseudomonas peritonitis that were poorly responsive to treatment guidelines of antibiotics and early catheter removal, and uncommonly complicated with ongoing intractable infections. An emergency exploratory laparotomy with extensive intraoperative peritoneal lavage and drainage was performed. The patients recovered dramatically and were transferred to hemodialysis permanently. These unusual cases show the possibility of persistent intra-abdominal infection that may extend extra-abdominally. Early diagnosis of persistent infection, timely surgical intervention, and concept of source control are of utmost importance.
