Tsai Yu-Chi, Tsai Ming-Kai, Kung Wen-Ching, Wang Chien-Yao
Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Front Med (Lausanne). 2024 Jul 17;11:1381262. doi: 10.3389/fmed.2024.1381262. eCollection 2024.
Peritoneal dialysis (PD)-associated peritonitis is a major cause of peritoneal dysfunction and failure. The main issue regarding the treatment is whether to remove the catheter surgically or to treat with antibiotics alone. Notably, PD-associated peritonitis is commonly caused by gram-positive cocci, but rarely by and . Here, we report a patient diagnosed with PD-associated peritonitis caused by and who presented with a fever, abdominal pain, and turbid dialysate and had been receiving PD for over 20 years. After 2 weeks of antibiotic treatment, the catheter in the patient was surgically removed. Culture and pathology results revealed pathogen growth, foreign body granuloma with chronic inflammation, and inflammatory cells with fibroblast infiltration. The patient was switched to hemodialysis. She eventually recovered and was discharged. The patient presented fair health at the 3-month follow-up. In conclusion, sequential dialysate white blood cell count may help clinicians decide the course of treatment and guide the timing of surgical intervention.
腹膜透析(PD)相关腹膜炎是腹膜功能障碍和衰竭的主要原因。治疗的主要问题是是否通过手术移除导管还是仅用抗生素治疗。值得注意的是,PD相关腹膜炎通常由革兰氏阳性球菌引起,但很少由 和 引起。在此,我们报告一例诊断为PD相关腹膜炎的患者,该患者由 和 引起,表现为发热、腹痛和透析液浑浊,且已接受PD治疗超过20年。经过2周的抗生素治疗后,该患者的导管被手术移除。培养和病理结果显示有病原菌生长、伴有慢性炎症的异物肉芽肿以及有成纤维细胞浸润的炎性细胞。该患者转为血液透析。她最终康复并出院。在3个月的随访中,患者健康状况良好。总之,连续透析液白细胞计数可能有助于临床医生决定治疗方案并指导手术干预的时机。