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- Title
Peritoneal dialysis-associated peritonitis caused by Tsukamurella inchonensis: a case report and literature review.
- Authors
Yamaguchi, Ryo; Kashiwagi, Mana; Ichijo, Kiyomi; Kobayashi, Yu; Matsuoka, Tomomi; Horikoshi, Shu; Takashima, Hiroyuki; Abe, Masanori
- Abstract
Background: Peritoneal dialysis (PD)-associated peritonitis is a serious complication that can lead to PD discontinuation and mortality. Tsukamurella species are uncommon opportunistic pathogens that can cause peritonitis, often necessitating catheter removal. Case presentation: A 46-year-old woman with a 1.5-year history of PD presented with fever and lower abdominal pain, along with cloudy peritoneal effluent showing an elevated cell count. Empiric antibiotic therapy with ciprofloxacin, cefazolin, and ceftazidime was started for PD-associated peritonitis. The peritoneal effluent culture yielded a gram-positive rod with weak acid-fast staining. A rebound in the cell count necessitated a switch of antibiotics to meropenem and vancomycin. This led to improvement, and the treatment was switched to oral levofloxacin on day 30 and the patient was discharged on day 35. Subsequently, 16S rRNA gene sequencing confirmed the isolate as Tsukamurella inchonensis. Conclusion: This case highlights the challenges in identifying and treating Tsukamurella peritonitis. Successful treatment without catheter removal in this case suggests that early detection and appropriate antibiotics may enable catheter salvage in this rare infection. However, further research is needed to establish optimal treatment strategies.
- Subjects
JAPAN; ANTIBIOTICS; PERITONEAL dialysis; PERITONITIS; ABDOMINAL pain; RARE diseases; ACTINOMYCETALES; TREATMENT effectiveness; FEVER; ORAL drug administration; DISCHARGE planning; CYTOMETRY; EARLY diagnosis
- Publication
Renal Replacement Therapy, 2024, Vol 10, Issue 1, p1
- ISSN
2059-1381
- Publication type
Article
- DOI
10.1186/s41100-024-00564-w