Sakaguchi Tetsuya, Tamura Hiroshi, Furuie Keishiro, Kuraoka Shohei, Nakazato Hitoshi
Department of Pediatrics, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Biomed Hub. 2024 Sep 13;9(1):128-133. doi: 10.1159/000541001. eCollection 2024 Jan-Dec.
Peritonitis is a significant complication of peritoneal dialysis (PD). Additionally, in severe or prolonged cases of peritonitis, the structure and function of the peritoneum may change, making it difficult to continue PD. Thus, identifying the causative agent and early administration of antibiotics are essential to minimize the risk of treatment failure. Meanwhile, bacterial peritonitis caused by nontuberculous (NTM) are difficult to identify. NTM are also among the most difficult organisms to eradicate. Oftentimes, removal of the peritoneal catheter and multiple antibiotics are required to eradicate NTM infections.
Herein, we report a case of peritonitis caused by in a 3-year-old boy undergoing PD. The patient had a history of an initial PD catheter exit site infection caused by that led to PD-associated peritonitis. Consequently, the catheter was removed, and the patient was switched to hemodialysis and treated with multiple antibiotics.
This rare cause of peritonitis is associated with a high mortality and severe morbidity and usually requires removal of the PD catheter as well as prolonged treatment with multiple antibiotics. When there is NTM infection around the PD catheter, such as in an ulcer, it is necessary to remove the catheter and transition to a hemodialysis until the infection has healed.
腹膜炎是腹膜透析（PD）的一种严重并发症。此外，在严重或长期的腹膜炎病例中，腹膜的结构和功能可能会发生变化，导致难以继续进行腹膜透析。因此，确定病原体并尽早使用抗生素对于将治疗失败的风险降至最低至关重要。同时，非结核分枝杆菌（NTM）引起的细菌性腹膜炎难以识别。NTM也是最难根除的微生物之一。通常，需要拔除腹膜导管并使用多种抗生素来根除NTM感染。
在此，我们报告一例3岁接受腹膜透析的男孩发生的由[未提及具体病菌]引起的腹膜炎病例。该患者曾有过因[未提及具体病菌]导致的初次腹膜透析导管出口处感染，进而引发与腹膜透析相关的腹膜炎。因此，导管被拔除，患者转为血液透析并接受多种抗生素治疗。
这种罕见的腹膜炎病因与高死亡率和严重发病率相关，通常需要拔除腹膜透析导管并进行长期的多种抗生素治疗。当腹膜透析导管周围存在NTM感染，如出现溃疡时，有必要拔除导管并转为血液透析，直至感染痊愈。
