Mihara Yu, Kado Hiroshi, Matsumoto Kenji, Kurose Ryo, Tsujinaka Erika, Nakai Kunihiro, Yamauchi Asuka, Hatta Tsuguru
Department of Nephrology, Omihachiman Community Medical Center, Japan.
Intern Med. 2024 Mar 1;63(5):707-710. doi: 10.2169/internalmedicine.2035-23. Epub 2023 Jul 12.
A 60-year-old man with end-stage renal disease due to nephrosclerosis had a peritoneal dialysis catheter (PD) embedded with stepwise initiation of peritoneal dialysis using Moncrief and Popovich's technique three months ago. PD was initiated three weeks after creating an exit site. He presented with abdominal pain and fever a day before admission and was diagnosed with PD-associated peritonitis caused by Streptococcus oralis. Medical consultation after admission revealed a history of wisdom tooth extraction following PD catheter placement, resulting in delayed wound healing. Transient bacteremia can occur after tooth extraction, leading to PD-associated peritonitis. Contemplating the oral milieu in patients undergoing PD is pertinent.
一名因肾硬化导致终末期肾病的60岁男性，三个月前植入了腹膜透析导管（PD），采用Moncrief和Popovich技术逐步开始腹膜透析。在建立出口部位三周后开始进行腹膜透析。入院前一天，他出现腹痛和发热，被诊断为由口腔链球菌引起的腹膜透析相关腹膜炎。入院后会诊发现，在放置腹膜透析导管后有拔除智齿的病史，导致伤口愈合延迟。拔牙后可能发生短暂菌血症，从而导致腹膜透析相关腹膜炎。考虑接受腹膜透析患者的口腔环境是很有必要的。
