Zewinger Stephen, Meier Clemens-Magnus, Fliser Danilo, Klingele Matthias
Clin Nephrol. 2014 Nov;82(5):341-6. doi: 10.5414/CN107704.
Mycobacterium fortuitum peritonitis is a rare complication in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). A 47-year-old patient was admitted to our tertiary hospital because of culture-negative peritonitis with persisting signs of infection despite adequate empirical antibiotic treatment. Although M. fortuitum was detected and the antibiotic regime subsequently amended, catheter removal was inevitable and the dialysis modality converted to hemodialysis (HD). After long-term antibiotic treatment and an additional latency of 4 months without signs of residual infection, reinitiation of CAPD was planned. Explorative laparoscopy prior to catheter reinsertion revealed multiple adhesions within the peritoneal cavity, preventing adequate catheter function. The clinical course of M. fortuitum peritonitis, the need for catheter removal and the description of peritoneal changes are discussed regarding to recent literature.
偶然分枝杆菌腹膜炎是持续性非卧床腹膜透析（CAPD）患者罕见的并发症。一名47岁患者因培养阴性腹膜炎入住我们的三级医院，尽管接受了充分的经验性抗生素治疗，但仍有持续感染迹象。虽然检测到偶然分枝杆菌并随后调整了抗生素治疗方案，但仍不可避免地拔除了导管，透析方式改为血液透析（HD）。经过长期抗生素治疗及4个月无残余感染迹象的潜伏期后，计划重新开始CAPD。在重新插入导管前进行的探查性腹腔镜检查发现腹腔内有多处粘连，影响导管正常功能。结合近期文献讨论了偶然分枝杆菌腹膜炎的临床病程、导管拔除的必要性以及腹膜变化的描述。
