Department of Nephrology, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China.
Department of Gastroenterology and Hepatology, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China.
Semin Dial. 2022 Mar;35(2):190-193. doi: 10.1111/sdi.13045. Epub 2021 Dec 10.
Refractory peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) caused by Burkholderia cepacia is very rare. Herein, we describe a case of B. cepacia-related refractory peritonitis and present a literature review of similar cases. A 62-year-old male patient presented with diffuse abdominal pain, bloating, and turbid peritoneal effluent. Initial dialysis effluent culture was negative for any microorganism. The patient initially underwent treatment with piperacillin-sulbactam. The second dialysis effluent culture was positive for gram stain and later tested positive for B. cepacia. Peritoneal dialysis (PD) catheter removal was recommended, and the patient agreed to undergo regular hemodialysis. To the best of our knowledge, this is the first case of B. cepacia-related refractory peritonitis in a patient undergoing CAPD with no history of a recent hospitalization. B. cepacia infections can result in death in some areas. Therefore, timely catheter removal and switching treatment to hemodialysis is recommended for patients with B. cepacia-related refractory peritonitis.
由洋葱伯克霍尔德菌引起的持续性不卧床腹膜透析（CAPD）患者的难治性腹膜炎非常罕见。在此，我们描述了一例与洋葱伯克霍尔德菌相关的难治性腹膜炎，并对类似病例进行了文献复习。一名 62 岁男性患者出现弥漫性腹痛、腹胀和浑浊的腹腔渗出液。最初的透析液培养未发现任何微生物。患者最初接受了哌拉西林-他唑巴坦治疗。第二次透析液培养革兰氏染色阳性，随后检测出洋葱伯克霍尔德菌阳性。建议取出腹膜透析（PD）导管，患者同意接受常规血液透析。据我们所知，这是首例无近期住院史的 CAPD 患者发生洋葱伯克霍尔德菌相关难治性腹膜炎的病例。在某些地区，洋葱伯克霍尔德菌感染可导致死亡。因此，对于发生与洋葱伯克霍尔德菌相关的难治性腹膜炎的患者，建议及时取出导管并将治疗切换为血液透析。
