Recurrent peritonitis relapse in a patient with atrial septal defect undergoing peritoneal dialysis: a case report

BMC Nephrology

Case Report

Shengqin Wu¹  Jingshu Sun¹  Jianying Wang¹ 

[1] Weifang People’s Hospital, No. 151 Guangwen Street, Kuiwen District, 261000, Weifang, China;

关键词: Peritoneal dialysis (PD);    Relapsing peritonitis;    Infective endocarditis (IE);    Atrial septal defect (ASD);    Case report;   

DOI  :  10.1186/s12882-022-03037-6

 received in 2021-07-10, accepted in 2022-12-09,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundPeritonitis is the most common complication in patients undergoing peritoneal dialysis (PD). Most patients recover with appropriate antibiotic treatment; however, when peritonitis repeatedly relapses, the cause of recurrence must be explored. The relationship between atrial septal defect (ASD), infective endocarditis (IE), and peritonitis is rarely reported. Here, we present a case of recurrent peritonitis due to Staphylococcus aureus in a patient with ASD and IE undergoing PD.Case presentationA 46-year-old woman with chronic renal failure secondary to chronic glomerulonephritis experienced three episodes of peritonitis within 80 days of starting PD. The patient had a history of untreated ASD without symptoms. After undergoing PD for approximately 35 days, the patient was admitted to our hospital on April 5, 2016, due to abdominal pain and fever for 1 week (maximum temperature of 38.5 °C) accompanied by chills and shivering. The PD effluent from the time of her admission was positive for S. aureus. Thereafter, peritonitis recurred each month. When the third episode of peritonitis occurred, transthoracic echocardiography was performed, and a vegetation measuring 9.5 × 6.4 mm attached to the surface of the right ventricle around the ventricular septal membrane was identified. Finally, the patient was diagnosed with IE. Then, ASD repair surgery was successfully performed after the infection was controlled. The patient was followed up for 5 years, with no further episodes of recurrence.ConclusionsWhen a patient with ASD undergoing PD develops peritonitis, especially relapsing peritonitis, the possibility of IE is significantly increased. ASD repair surgery may be an important contributing factor to prevent peritonitis recurrence.

【 授权许可】

CC BY   
© The Author(s) 2022