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脓肿分枝杆菌引起的腹膜透析导管相关腹膜炎:真的是感染吗?

Peritoneal Dialysis Catheter-Associated Peritonitis Caused by Mycobacterium abscessus: A True Infection?

作者信息

Khin Ei, Rodriguez Rosa, Walker Sarah K, Handal Gilbert

机构信息

Pediatric Nephrology, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA.

Pediatric Nephrology, El Paso Children's Hospital, El Paso, USA.

出版信息

Cureus. 2024 Sep 5;16(9):e68721. doi: 10.7759/cureus.68721. eCollection 2024 Sep.

Abstract

A nine-year-old male with trisomy 21, end-stage renal disease (ESRD) due to reflux nephropathy presented with suspected peritoneal dialysis (PD) catheter-associated peritonitis. One week after receiving an intraperitoneal antibiotic, he presented again with persistent peritonitis symptoms and bloody PD fluid. He underwent exploratory laparotomy, abdominal washout, and PD catheter removal. ( was found in the intraoperative peritoneal fluid culture. After the catheter removal, the child's symptoms significantly improved without antimicrobial medications. He was maintained on hemodialysis three times a week and underwent a successful kidney transplant eight months after this episode. Non-tuberculous mycobacterial peritonitis should be considered in patients with culture-negative peritonitis when there is no intraperitoneal antibiotic response.  is a rapidly growing atypical found in the environment and can contaminate medical devices. Our case involved an infection from a contaminated PD catheter since the patient's symptoms improved after PD catheter removal.

摘要

一名9岁男性,患有21三体综合征,因反流性肾病导致终末期肾病(ESRD),出现疑似腹膜透析(PD)导管相关腹膜炎。在接受腹腔内抗生素治疗一周后,他再次出现持续性腹膜炎症状和血性腹膜透析液。他接受了剖腹探查、腹腔冲洗和PD导管拔除术。术中腹膜液培养发现(此处原文缺失具体病菌名称)。拔除导管后,患儿症状在未使用抗菌药物的情况下显著改善。他每周接受三次血液透析,并在此事件发生八个月后成功进行了肾脏移植。当腹膜内抗生素治疗无效且培养阴性的腹膜炎患者时,应考虑非结核分枝杆菌腹膜炎。(此处原文缺失具体病菌名称)是一种在环境中快速生长的非典型病菌,可污染医疗设备。我们的病例涉及受污染的PD导管感染,因为拔除PD导管后患者症状有所改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f39/11453173/07b9ac9c9afa/cureus-0016-00000068721-i01.jpg

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