Peritonitis following Colonoscopy in a Peritoneal Dialysis Patient

1990 ◽  
Vol 10 (1) ◽  
pp. 97-98 ◽  
Author(s):  
Susan M. Ray ◽  
Beth Piraino ◽  
Jean Holley
Keyword(s):  
Peritoneal Dialysis ◽  
Antibiotic Prophylaxis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Dialysis Patient ◽  
Aminoglycoside Antibiotic ◽  
Peritoneal Dialysis Patient ◽  
Colonoscopic Polypectomy ◽  
Gram Positive ◽  
Gram Negative ◽  
Bacterial Peritonitis

A 65-year-old woman on continuous ambulatory peritoneal dialysis (CAPD) developed blood-tinged dialysate and bacterial peritonitis following a colonoscopic polypectomy. She grew multiple anaerobic organisms in her dialysate despite antibiotic prophylaxis with vancomycin and gentamicin prior to the procedure. This case confirms the need for broad spectum antibiotic prophylaxis prior to colonoscopic procedures, especially if polypectomy is planned. The antibiotic chosen should cover anaerobes as well as gram-positive and gram-negative enteric organisms. We suggest the use of ampicillin, clindamycin, and an aminoglycoside antibiotic for this prophylaxis.

scholarly journals Acute Peritonitis Caused by Propionibacterium Acnes in a Peritoneal Dialysis Patient

2017 ◽  
Vol 15 (1) ◽  
pp. 33-34
Author(s):  
Nikolina Basic-Jukic ◽  
Vesna Furic-Cunko ◽  
Ivana Juric ◽  
Lea Katalinic ◽  
Ana Rukavina ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Human Skin ◽  
Dialysis Patient ◽  
Propionibacterium Acnes ◽  
Peritoneal Dialysis Patient ◽  
Growth Conditions ◽  
Anaerobic Growth ◽  
Gram Positive ◽  
Acute Peritonitis ◽  
Clinical Conditions

AbstractPropionibacterium acnes is a gram-positive human skin commensal that is involved in the pathogenesis of acne and prefers anaerobic growth conditions. It has been considered as a low virulence pathogen in different clinical conditions. We present the case of acute peritonitis caused by Propionibacterium acnes in a peritoneal dialysis patient.

scholarly journals Peritonitis Associated with Vancomycin-ResistantLactobacillus rhamnosus in a Continuous Ambulatory Peritoneal Dialysis Patient: Organism Identification, Antibiotic Therapy, and Case Report

1998 ◽  
Vol 36 (6) ◽  
pp. 1781-1783 ◽  
Author(s):  
Günter Klein ◽  
Edith Zill ◽  
Ralf Schindler ◽  
Jacobus Louwers
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Dialysis Patient ◽  
Susceptibility Testing ◽  
Lactobacillus Rhamnosus ◽  
Peritoneal Dialysis Patient ◽  
Antibiotic Susceptibility Testing ◽  
Coagulase Negative Staphylococci ◽  
Pure Cultures ◽  
Organism Identification

A case of Lactobacillus rhamnosus-associated peritonitis in a patient undergoing continuous ambulatory peritoneal dialysis is reported. The patient was treated with vancomycin after isolation of glycopeptide-susceptible coagulase-negative staphylococci. After a skin rash developed, vancomycin was discontinued and replaced with teicoplanin. Seven weeks after the glycopeptide therapy was discontinued, a Lactobacillus strain was isolated in pure cultures. The isolate was identified first incorrectly as L. acidophilus but later correctly as L. rhamnosus. Antibiotic susceptibility testing showed that the isolate was resistant to glycopeptides but susceptible to several other antibiotics. The antibiotic treatment was then switched to imipenem and was successful.

The Impact of Peritonitis on Peritoneal and Systemic Acid-Base Status of Patients on Continuous Ambulatory Peritoneal Dialysis

1994 ◽  
Vol 14 (1) ◽  
pp. 61-65 ◽  
Author(s):  
Jacques J. Sennesael ◽  
Godelieve C. De Smedt ◽  
Patricia Van der Niepen ◽  
Dierik L. Verbeelen
Keyword(s):  
Staphylococcus Aureus ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Acid Base ◽  
Gram Positive ◽  
Gram Negative ◽  
Arterial Blood ◽  
Blood Ph ◽  
Acid Base Status ◽  
And Staphylococcus Aureus

Objective To assess the possible effects of peritonitis on peritoneal and systemic acid-base status. Design pH, pCO2, lactate, and total leukocyte and differential count were simultaneously determined in the overnight dwell peritoneal dialysis effluent (PDE) and arterial blood in noninfected patients (controls) and on days 1, 3, and 5 from the onset of peritonitis. Setting University multidisciplinary dialysis program. Patients Prospective analysis of 63 peritonitis episodes occurring in 30 adult CAPD patients in a single center. Results In controls, mean (±SD) acid-base parameters were pH 7.41 ±0.05, pCO2 43.5±2.6 mm Hg, lactate 2.5±1.5 mmol/L in the PDE, and pH 7.43±0.04, PaCO2 36.8±3.8 mm Hg, lactate 1.4±0.7 mmol/L in the blood. In sterile (n=6), gram-positive (n=34), and Staphylococcus aureus (n=9) peritonitis PDE pH's on day 1 were, respectively, 7. 29±0.07, 7. 32±0.07, and 7.30±0.08 (p<0.05 vs control). In gram -negative peritonitis (n=14) PDE pH was 7.21 ±0.08 (p<0.05 vs all other groups). A two-to-threefold increase in PDE lactate was observed in all peritonitis groups, but a rise in pCO2 was only seen in gram -negative peritonitis. Acid-base profile of PDE had returned to control values by day 3 in sterile, gram -positive and Staphylococcus aureus peritonitis and by day 5 in gramnegative peritonitis. Despite a slight increase in plasma lactate on the first day of peritonitis, arterial blood pH was not affected by peritonitis. Conclusion PDE pH is decreased in continuous ambulatory peritoneal dialysis (CAPD) peritonitis, even in the absence of bacterial growth. In gram-negative peritonitis, PDE acidosis is more pronounced and prolonged, and pCO2 is markedly increased. Arterial blood pH is not affected by peritonitis.

scholarly journals Pleuroperitoneal Leak: An Unusual Cause of Acute Shortness of Breath in a Peritoneal Dialysis Patient

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
D. P. Ramaema ◽  
P. Mpikashe
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Dialysis Patient ◽  
Peritoneal Dialysis Patient ◽  
Shortness Of Breath ◽  
Pleural Effusions ◽  
Dialysis Patients ◽  
Case Presentation ◽  
Peritoneal Scintigraphy ◽  
Uncommon Complication

Introduction. Pleuroperitoneal leak is an uncommon complication of continuous ambulatory peritoneal dialysis (CAPD), with an estimated incidence of 1.6%. It should be suspected in these patients when they present with recurrent unilateral pleural effusions and/or acute shortness of breath following dialysate infusion.Case Presentation. We present the case of a 25-year-old female patient who had acute hydrothorax as a result of pleuroperitoneal leak complicating continuous ambulatory peritoneal dialysis (CAPD), which was confirmed on peritoneal scintigraphy.Conclusion. Continuous ambulatory peritoneal dialysis patients presenting with acute shortness of breath and/or recurrent unilateral pleural effusion should be investigated with peritoneal scintigraphy to exclude pleuroperitoneal leak.

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