Burkholderia cepacia —A rare but important cause of refractory peritonitis in patients with continuous ambulatory peritoneal dialysis: A case report and literature review

2021 ◽  
Author(s):  
Xiu Huang ◽  
Ting Yang ◽  
Min Li ◽  
Chendan Wang ◽  
Yun Zhou ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Case Report ◽  
Literature Review ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Burkholderia Cepacia ◽  
Refractory Peritonitis

Case Report. Candida lusitaniae peritonitis in a patient on continuous ambulatory peritoneal dialysis

Mycoses ◽  
2002 ◽  
Vol 45 (3-4) ◽  
pp. 120-122 ◽  
Author(s):  
S. Cinar ◽  
A. Nedret Koc ◽  
H. Taskapan ◽  
A. Dogukan ◽  
B. Tokgoz ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Case Report ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Candida Lusitaniae

Bi-microbial Healthcare-Associate Endocarditis caused by Enterococcus faecalis and Burkholderia cepacia: A Case Report and literature review

2020 ◽  
Vol 02 ◽  
Author(s):  
Masood Ghori ◽  
Nadya O. Al Matrooshi ◽  
Samir Al Jabbari ◽  
Ahmed Bafadel ◽  
Gopal Bhatnagar
Keyword(s):  
Case Report ◽  
Infective Endocarditis ◽  
Literature Review ◽  
Enterococcus Faecalis ◽  
Surgical Management ◽  
Burkholderia Cepacia ◽  
Clinical Presentation ◽  
Complicated Course ◽  
Healthcare Associated ◽  
Echocardiographic Findings

: Infective Endocarditis (IE), a known complication of hemodialysis (HD), has recently been categorized as Healthcare-Associated Infective Endocarditis (HAIE). Single pathogen bacteremia is common, polymicrobial endocardial infection is rare in this cohort of the patients. We report a case of endocarditis caused by Enterococcus faecalis (E. faecalis) and Burkholderia cepacia (B. cepacia), a first ever reported combination of a usual and an unusual organism, respectively, in a patient on HD. Clinical presentation of the patient, its complicated course ,medical and surgical management ,along with microbial and echocardiographic findings is presented herein. The authors believe that presentation of this case of HAIE may benefit and contribute positively to cardiac science owing to the rare encounter of this organism as a pathogen in infective endocarditis and the difficulties in treating it.

MO697TUBERCULOUS PERITONITIS WITH HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS IN A PATIENT ON CONTINUOUS AMBULATORY PERITONEAL DIALYSIS: A CASE REPORT

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Manisha Dassi ◽  
Anil JhaJhria ◽  
Neeru Aggarwal ◽  
Lakshmikant Jha
Keyword(s):  
Weight Loss ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Tuberculous Peritonitis ◽  
Low Grade ◽  
Surgical Wound ◽  
Laboratory Parameters ◽  
Criteria For Diagnosis ◽  
Refractory Peritonitis

Abstract Background and Aims Tuberculosis is a leading cause of morbidity and mortality worldwide. Tuberculous peritonitis in patients on Continuous Ambulatory Peritoneal Dialysis (CAPD), though uncommon, has been reported from different parts of the world. Hemophagocytic lymphohistiocytosis (HLH) is a rare systemic inflammatory disorder characterized by uncontrolled proliferation of lymphocytes & histiocytes and is reported to have high mortality. Secondary forms of HLH have been described for various diseases. Here, we report a case of HLH secondary to Tuberculous peritonitis in a patient of End Stage Renal Disease (ESRD) on CAPD. Method A 49 years old male ESRD patient, on CAPD presented with peritonitis and was initially managed with antibiotics. He required catheter explantation in view of refractory peritonitis and was switched to haemodialysis. The patient continued to have low grade fever, yellowish discharge from infra-umbilical CAPD catheter explantation surgical wound along with lower abdominal pain & tenderness. He was lost to follow up and presented again after 1 month with fever, weight loss, multiple cutaneous ecchymotic spots and copious amount of yellowish discharge from infra-umbilical surgical wound. On examination, he had fever, conjunctival pallor, hepatosplenomegaly and a 5 cm infra-umbilical midline poorly healed discharging surgical scar with surrounding skin erythema and induration. Blood investigations revealed Hb 5.1 gm/dl, TLC 1500/uL, Plts 32000/uL, Ferritin 1053 ng/ml, TG 350 mg/dl, LDH 650 U/l, Bil T/D 1.3/1.0 mg/dl, OT/PT 160/174 IU/l, ALP 219 U/l, GGT 238 U/l, TP/Alb 5.2/2.5 gm/dl, APTT C/T 27.9/63.0, INR 1.27. NCCT abdomen revealed hepatosplenomegaly, loculated collection in right subphrenic region extending into the abdominal and pelvic cavity, anterior abdominal wall defect infero-right lateral to the umbilicus and generalised increased density in mesenteric fat. Diagnostic sub-phrenic fluid Aspirate analysis revealed a yellow turbid fluid with TLC 22300, ADA 106 U/L and positive Real Time PCR for Mycobacterium tuberculosis complex. Aspirate pyogenic and fungal cultures were sterile. Bone marrow evaluation revealed marked degree of histiocytic hemophagocytosis. Patient fulfilled six out of eight criteria for diagnosis of HLH. He was started on Anti Tubercular Treatment along with dexamethasone. He gradually became afebrile with resolution of infra-umbilical wound discharge, improvement in clinical and laboratory parameters. Results We report a case of HLH secondary to Tuberculous peritonitis in a patient of ESRD. The patient was on CAPD and required catheter explantation in view of Refractory peritonitis. Despite explantation and adequate antibiotics, he continued to have fever, discharge from surgical wound, pain abdomen, weight loss and poor appetite. Further evaluation revealed evidence of Tuberculous Peritonitis. In addition, the patient fulfilled six out of eight criteria for diagnosis of HLH. The patient was managed with Anti Tubercular Treatment along with Dexamethasone and he showed a gradual improvement in overall clinical and laboratory parameters. Conclusion Secondary HLH may occur after Tuberculous peritonitis in patient of ESRD on CAPD. Refractory peritonitis with hyperferritenemia, cytopenias, hypertriglyceridemia should raise the suspicion for HLH. Timely identification and treatment of HLH may improve patient outcomes.

CAPD Catheter Exit-Site and Tunnel Infection with Fungal Etiology—Treatment and Catheter Reinsertion for an Extremely Rare Complication

2017 ◽  
Vol 37 (2) ◽  
pp. 237-239
Author(s):  
Manmeet Singh Jhawar ◽  
Jasmin Das ◽  
Pratish George ◽  
Anil Luther
Keyword(s):  
Candida Albicans ◽  
Peritoneal Dialysis ◽  
Case Report ◽  
Fungal Infection ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Rare Complication ◽  
Exit Site ◽  
Duration Of Therapy ◽  
Tunnel Infection ◽  
Few Data

Fungal infection is an extremely rare etiology of exit-site and tunnel infection in patients on continuous ambulatory peritoneal dialysis (CAPD). There are few data available regarding its management—especially choice of antifungals, duration of therapy, and removal of catheter. There are no guidelines pertaining to reinsertion of the CAPD catheter following fungal exit-site and tunnel infection. This case report highlights Candida albicans as a rare cause of exit-site and tunnel infection of the CAPD catheter. The catheter was removed and the patient received appropriate antifungal therapy followed by reinsertion of the CAPD catheter and re-initiation on CAPD.

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