Korean J Nephrol.  2009 Jul;28(4):365-369.

A Case of Continuous Ambulatory Peritoneal Dialysis Peritonitis Due to Brevundimonas vesicularis

• Kwak SD
• Choi SY
• Park JY
• Yim JK
• Chun JH
• Kim TW
• Seo BJ

Abstract

A 53-year-old male was hospitalized with abdominal pain and turbid peritoneal fluid. He was diagnosed with hypertension, diabetic nephropathy and started continuous ambulatory peritoneal dialysis (CAPD) 4 years ago. Initial peritoneal fluid analysis demonstrated CAPD peritonitis. As initial antibiotic therapy, ceftazidime/vancomycin were injected intraperitoneally. But drug sensitivity test revealed these regimens were ineffective. On sixth hospital day, Brevundimonas vesicularis (B. vesicularis) was cultured from peritoneal fluid, this strain was susceptible to imipenem, piperacillin and resistant to ceftazidime. Accordingly we changed the antibiotics to imipenem, which was administered for 14 days, but analysis of peritoneal fluid was seldom improved. Finally, CAPD catheter was removed, and hemodialysis was started. After CAPD catheter removal, peritonitis improved rapidly. B.vesicularis is a rare opportunistic organism in CAPD peritonitis. Because this peritonitis may not improve in spite of medical treatment with susceptible antibiotics, CAPD catheter must be removed finally.

Keyword

Pseudomonas; Continuous ambulatory peritoneal dialysis; Peritonitis

MeSH Terms

Abdominal Pain
Anti-Bacterial Agents
Ascitic Fluid
Catheters
Ceftazidime
Diabetic Nephropathies
Humans
Hypertension
Imipenem
Male
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory
Peritonitis
Piperacillin
Pseudomonas
Renal Dialysis
Sprains and Strains
Anti-Bacterial Agents
Ceftazidime
Imipenem
Piperacillin