Fatal peritoneal dialysis-associated peritonitis caused by Mycobacterium mageritense: a case report with review

Renal Replacement Therapy

Case Report

Rei Iio¹  Tomoya Naka¹  Ryuta Uwatoko¹  Terumasa Hayashi¹  Kazuhiro Okamoto¹  Saki Bessho¹  Yoshiyasu Ueda¹  Nobuhiro Hashimoto¹  Nao Kani¹  Hiromitsu Miyakawa¹  Shuzo Makino¹ 

[1]Department of Kidney Disease and Hypertension, Osaka General Medical Center, 558-8558, Osaka, Japan

关键词: Nontuberculous mycobacteria (NTM);    Mycobacterium mageritense;    Peritonitis;    Peritoneal dialysis;   

DOI  :  10.1186/s41100-023-00457-4

 received in 2022-11-04, accepted in 2023-01-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPeritonitis is a serious and potentially fatal complication of peritoneal dialysis. We report a case of fatal peritonitis caused by Mycobacterium mageritense that was detected for the first time in peritonitis.Case presentationA male patient in his 60 s undergoing peritoneal dialysis was admitted for catheter diversion with exit-site renewal. The patient had a refractory exit-site infection. Mycobacterial culture was not performed at the exit site prior to admission. After the surgery, the patient developed a fever, and a cloudy effluent was observed. Various antibiotics, including anti-tuberculosis drugs, were administered; however, his symptoms did not improve. The catheter was removed on the thirty-seventh day of admission. Bacteria positive for Ziehl–Neelsen staining were found in the peritoneal sample collected during the surgery. Since nontuberculous mycobacteria were considered the cause of peritonitis, the patient was administered imipenem/cilastatin, amikacin, and clarithromycin. However, he died of septic shock on the fifty-first day after admission. Mycobacterium mageritense was detected in the ascites culture after death.ConclusionThis is, to our knowledge, the first report of peritonitis caused by Mycobacterium mageritense. In patients undergoing peritoneal dialysis, when a refractory exit-site infection is observed, mycobacterial culture is necessary to prevent the development of peritonitis.

【 授权许可】

CC BY   
© The Author(s) 2023

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