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终末期肾病患者接受自动化腹膜透析时发生的长奈瑟菌介导的腹膜炎:一例报告及文献综述

Neisseria elongata -mediated peritonitis in an end-stage renal disease patient on automated peritoneal dialysis, A case report and literature review.

作者信息

Alsayed Ahmed, Abdalla El Mustafa, Ali Bashir, Hatem Ahmed, Albsheer Khalid, Elhadi Mohamed, Makawi Amna

机构信息

Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.

出版信息

Ann Med Surg (Lond). 2022 Nov 15;84:104920. doi: 10.1016/j.amsu.2022.104920. eCollection 2022 Dec.

Abstract

INTRODUCTION

Peritoneal dialysis (PD) can result in peritonitis, which frequently causes severe and near-fatal clinical implications if left untreated. Usually, Gram-positive bacteria are the most common organisms involved. Uncommonly recognized as the cause of peritonitis in PD patients, Neisseria Elongata is a gram-negative nasal and oropharyngeal normal flora organism.

CASE PRESENTATION

We report a rare case of a 29-year-old man who had received automated peritoneal dialysis for six years and had Neisseria Elongata peritonitis.

DISCUSSION

Several case Reports of niseria-related peritonitis may point to the potential pathogenicity of such organisms and suggest that many cases of culture-negative peritonitis may have been misdiagnosed. Poor nutrition and chronic kidney disease have been suggested as potential risk factors for Neisseria elongata peritonitis [8], both of which are present in our patient. With appropriate antibiotic use, most of the cases respond well to empirical treatment.

CONCLUSION

Although rare, Neisseria Elongata can lead to Peritoneal Dialysis catheter Peritonitis that, in some cases, require changing to hemodialysis.

摘要

引言

腹膜透析(PD)可导致腹膜炎,如果不治疗,常可引起严重且近乎致命的临床后果。通常,革兰氏阳性菌是最常见的致病微生物。长奈瑟菌是一种革兰氏阴性的鼻腔和口咽部正常菌群微生物,在腹膜透析患者腹膜炎病因中较少被认识。

病例报告

我们报告一例罕见病例,一名29岁男性接受自动化腹膜透析6年,发生了长奈瑟菌腹膜炎。

讨论

几例与奈瑟菌相关的腹膜炎病例报告可能表明此类微生物具有潜在致病性,并提示许多培养阴性的腹膜炎病例可能被误诊。营养不良和慢性肾脏病被认为是长奈瑟菌腹膜炎的潜在危险因素[8],这两个因素在我们的患者中均存在。通过适当使用抗生素,大多数病例对经验性治疗反应良好。

结论

尽管罕见,但长奈瑟菌可导致腹膜透析导管相关性腹膜炎,在某些情况下需要改为血液透析。

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