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不常见的腹膜炎病例:五例病例系列。

Unusual cases of peritonitis: A case series of five patients.

机构信息

Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Division of Nephrology, Department of Medicine, Mount Sinai Beth Israel, New York, New York, USA.

出版信息

Semin Dial. 2023 May-Jun;36(3):255-262. doi: 10.1111/sdi.13121. Epub 2022 Aug 5.

Abstract

INTRODUCTION

Peritonitis is a complication in patients on peritoneal dialysis that frequently results from touch contamination. Most cases of peritoneal dialysis-related peritonitis are caused by skin organisms. Herein, we are presenting a series of peritonitis cases with unusual organisms in a single home dialysis center at an academic hospital in New York City.

METHODS

The records of five patients with an unusual cause of peritonitis were reviewed by a clinician. We have chronologically tabulated the cell count of the dialysate, microbiologic cultures, and antibiotics received by each patient. Additionally, both a table and figure detail the microbiologic organisms that our dialysis unit encountered over the 3-year period concurrent with the infections reported.

RESULTS

The first patient presented with refractory polymicrobial peritonitis due to a liver abscess. Another patient presented with diverticulitis and developed enteric peritonitis with various organisms. The following patient had peritonitis in the setting of bowel pathologies and from Rhizobium after exposure to plants. The next patient developed Pasteurella peritonitis from his cat. The final patient developed multiple episodes of peritonitis from organisms including flora native to soil and water.

CONCLUSION

These uncommon cases of peritonitis with unusual circumstances bring awareness to various elements that can lead to peritonitis.

摘要

简介

腹膜炎是腹膜透析患者的一种并发症,通常由接触污染引起。大多数腹膜透析相关性腹膜炎是由皮肤微生物引起的。在此,我们报告了在纽约市一家学术医院的一个家庭透析中心中,一系列由不常见微生物引起的腹膜炎病例。

方法

通过临床医生对五名腹膜炎患者的记录进行了回顾。我们按时间顺序列出了每位患者的透析液细胞计数、微生物培养和接受的抗生素。此外,表格和图表详细列出了我们透析单位在报告感染的同时遇到的 3 年期间的微生物。

结果

第一例患者因肝脓肿导致难治性多微生物腹膜炎。另一名患者因憩室炎并出现各种微生物引起的肠源性腹膜炎。接下来的患者在肠道疾病的背景下并在接触植物后发生根瘤菌性腹膜炎。下一位患者因接触猫而发生巴氏杆菌性腹膜炎。最后一位患者发生了多次腹膜炎,其病原体包括土壤和水中的原生菌群。

结论

这些不同寻常的腹膜炎病例及其特殊情况引起了对可能导致腹膜炎的各种因素的认识。

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