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Tsai YC, Tsai MK, Kung WC, Wang CY. Peritonitis caused by Listeria monocytogenes and Burkholderia cepacia in a patient on peritoneal dialysis: a case report. Front Med (Lausanne) 2024; 11:1381262. [PMID: 39086945 PMCID: PMC11288804 DOI: 10.3389/fmed.2024.1381262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 07/08/2024] [Indexed: 08/02/2024] Open
Abstract
Peritoneal dialysis (PD)-associated peritonitis is a major cause of peritoneal dysfunction and failure. The main issue regarding the treatment is whether to remove the catheter surgically or to treat with antibiotics alone. Notably, PD-associated peritonitis is commonly caused by gram-positive cocci, but rarely by Listeria monocytogenes and Burkholderia cepacia. Here, we report a patient diagnosed with PD-associated peritonitis caused by L. monocytogenes and B. cepacia who presented with a fever, abdominal pain, and turbid dialysate and had been receiving PD for over 20 years. After 2 weeks of antibiotic treatment, the catheter in the patient was surgically removed. Culture and pathology results revealed pathogen growth, foreign body granuloma with chronic inflammation, and inflammatory cells with fibroblast infiltration. The patient was switched to hemodialysis. She eventually recovered and was discharged. The patient presented fair health at the 3-month follow-up. In conclusion, sequential dialysate white blood cell count may help clinicians decide the course of treatment and guide the timing of surgical intervention.
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Affiliation(s)
- Yu-Chi Tsai
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
- Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ming-Kai Tsai
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Wen-Ching Kung
- Division of General Surgery, Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Chien-Yao Wang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
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Cox VF, Perez‐Albela A, Ramirez M, Commins R. Listeria peritonitis in a patient on hemodialysis for end-stage renal disease secondary to lupus nephritis-a case report. Clin Case Rep 2023; 11:e7938. [PMID: 37736474 PMCID: PMC10509335 DOI: 10.1002/ccr3.7938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/11/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
Key Clinical Message Patients with a recent history of peritoneal dialysis catheter removal in the setting of immunosuppression should be monitored for rare Listeria bacterial peritonitis. This infection should be managed with ampicillin and gentamicin. Abstract There are scattered reports to date of patients with peritonitis caused by Listeria monocytogenes. Listeria peritonitis is more commonly reported in patients with cirrhosis and those receiving peritoneal dialysis. We present a case of L. monocytogenes peritonitis in a patient with end-stage renal disease due to lupus nephritis actively on hemodialysis months after peritoneal dialysis catheter removal.
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Affiliation(s)
| | | | - Michael Ramirez
- Department of Internal MedicineMedStar Georgetown University HospitalWashingtonDCUSA
| | - Ryan Commins
- Department of Internal MedicineMedStar Georgetown University HospitalWashingtonDCUSA
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Guía clínica de la Sociedad Española de Nefrología para la prevención y tratamiento de la infección peritoneal en diálisis peritoneal. Nefrologia 2022. [DOI: 10.1016/j.nefro.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Masaki C, Matsushita K, Inoue T, Shima H, Chikakiyo M, Yamada M, Shirono R, Tashiro M, Tada H, Takamatsu N, Wariishi S, Okada K, Minakuchi J. Splenic abscess diagnosed following relapsing sterile peritonitis in a peritoneal dialysis patient: A case report with literature review. Semin Dial 2021; 34:245-251. [PMID: 33609413 DOI: 10.1111/sdi.12953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/31/2020] [Indexed: 11/30/2022]
Abstract
Peritoneal dialysis (PD)-related peritonitis is sometimes complicated with other infections; however, few cases of splenic abscess have been reported. We present the case of a 64-year-old PD patient with complicated splenic abscesses diagnosed following relapsing sterile peritonitis. After PD induction, he presented with turbid peritoneal fluid and was diagnosed with PD-related peritonitis. A plain abdominal computed tomography (CT) did not reveal any intra-abdominal focus of infection. After empiric intravenous antibiotics, the peritoneal dialysate was initially cleared, with a decrease in dialysate white blood cells (WBC) to 20/µL. However, WBC and C-reactive protein (CRP) levels remained elevated. A contrast-enhanced abdominal CT showed two areas of low-density fluid with no enhancement in a mildly enlarged spleen, making it difficult to distinguish abscesses from cysts. Due to relapsing sterile peritonitis, we performed an abdominal ultrasonography, and suspected splenic abscesses due to rapid increase in size. Repeated imaging tests were useful in establishing a diagnosis of splenic abscesses. Considering the persistent elevation of WBC and CRP levels, imaging findings, and episodes of relapsing peritonitis, we comprehensively formed the diagnosis, and performed a splenectomy as a rescue therapy. We should consider the possibility of other infectious foci with persistent inflammation after resolving PD-related peritonitis.
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Affiliation(s)
- Chiaki Masaki
- Department of Laboratory, Kawashima Hospital, Tokushima, Japan
| | - Kenta Matsushita
- Department of Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Tomoko Inoue
- Department of Kidney Disease, Kawashima Hospital, Tokushima, Japan
| | - Hisato Shima
- Department of Kidney Disease, Kawashima Hospital, Tokushima, Japan
| | - Motoya Chikakiyo
- Department of Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Mayumi Yamada
- Department of Laboratory, Kawashima Hospital, Tokushima, Japan
| | - Ryozo Shirono
- Department of Radiology, Kawashima Hospital, Tokushima, Japan
| | - Manabu Tashiro
- Department of Kidney Disease, Kawashima Hospital, Tokushima, Japan
| | - Hiroaki Tada
- Department of Laboratory, Kawashima Hospital, Tokushima, Japan
| | | | - Seiichiro Wariishi
- Department of Cardiovascular Surgery, Kawashima Hospital, Tokushima, Japan
| | - Kazuyoshi Okada
- Department of Kidney Disease, Kawashima Hospital, Tokushima, Japan
| | - Jun Minakuchi
- Department of Kidney Disease, Kawashima Hospital, Tokushima, Japan
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Listeria monocytogenes Peritonitis in a Patient Receiving Continuous Ambulatory Peritoneal Dialysis: A Case Report and Review of the Literature. Case Rep Nephrol 2021; 2021:6681629. [PMID: 33575047 PMCID: PMC7861955 DOI: 10.1155/2021/6681629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 11/21/2022] Open
Abstract
Listeria monocytogenes is a rare cause of peritoneal dialysis-related peritonitis. Only a handful of cases have been reported, and the optimal management is still uncertain. We present a case of Listeria monocytogenes peritonitis and perform a review of the literature to elucidate optimal antibiotic therapy.
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Mat O, Gankam F, Goubella A, Colombie V, Blecic S, Mat Q, Philippart P. Forty years of peritoneal dialysis Listeria peritonitis: Case and review. Perit Dial Int 2020; 41:337-340. [PMID: 33025862 DOI: 10.1177/0896860820962934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Infections with Listeria monocytogenes (LM) are very uncommon and severe especially in immunocompromised people. We report a continuous cycling peritoneal dialysis (CCPD) patient who presented initially disseminated listeriosis with peritonitis. He was successfully treated with intraperitoneal and intravenous ampicillin but died unfortunately from a cardiorespiratory arrest due to food inhalation. It is the 20th case of such peritonitis mentioned among PD patients and the first reported in Belgium. This case illustrates the importance of a systematic approach to get quick diagnosis and effective antibiotic readjustment. Empiric therapy is not effective on Listeria which is naturally resistant to cephalosporins and poorly sensitive to vancomycin. Ampicillin is the first-line antibiotic. In case of penicillin allergy, trimethoprim-sulfamethoxazole or erythromycin can be used successfully. Identification of LM serotype has a prognostic value. PD educative programmes should recommend to avoid unpasteurized dairy products to prevent listeriosis.
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Affiliation(s)
- Olivier Mat
- Department of Nephrology, EpiCURA, Ath, Belgium
| | | | | | | | | | - Quentin Mat
- Department of Otorhinolaryngology, C.H.U. Charleroi, Charleroi, Belgium
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Boss K, Wiegard-Szramek I, Dziobaka J, Kribben A, Dolff S. Intraperitoneal ampicillin treatment for peritoneal dialysis- related peritonitis with Listeria monocytogenes - a case report. BMC Nephrol 2020; 21:404. [PMID: 32948148 PMCID: PMC7501657 DOI: 10.1186/s12882-020-02068-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Peritoneal dialysis (PD)-related peritonitis is a rare but serious complication and is associated with increased morbidity and mortality rates. It is most commonly caused by Staphylococcus aureus or Staphylococcus epidermidis, but infection with Listeria monocytogenes may also occur. Recommendations for antibiotic treatment of a Listeria infection are currently based on a small number of case reports and suggest the administration of ampicillin. But unlike vancomycin or gentamicin, for ampicillin the route of application, the dosage, and the duration of treatment have not yet been established. We report a case in which PD-associated peritonitis due to Listeria infection was treated with ampicillin administered intravenously and intraperitoneally, separately and in combination. CASE PRESENTATION A 72-year-old man with chronic kidney disease stage 5 dialysis (CKDG5D) secondary to hypertension and diabetes was hospitalised in April 2020 because of PD-related peritonitis caused by a Listeria infection. In accordance with the results of resistance tests, the patient was treated with intravenous ampicillin at a dosage of 6 g twice daily. After initial treatment the leukocyte count in the PD effluent had decreased substantially, but it was permanently reduced only with the addition of intraperitoneal ampicillin (4 g daily). Efficient serum concentrations of ampicillin were determined for both routes of administration, intravenous and intraperitoneal. CONCLUSION This is the first case report demonstrating that PD-related peritonitis due to Listeria monocytogenes infection can be treated with intraperitoneal ampicillin and monitored by the determination of peripheral serum concentrations of ampicillin.
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Affiliation(s)
- Kristina Boss
- Department of Nephrology, University Hospital Essen, University-Duisburg Essen, 45147, Essen, Germany.
| | - Ina Wiegard-Szramek
- Department of Nephrology, University Hospital Essen, University-Duisburg Essen, 45147, Essen, Germany
| | - Jan Dziobaka
- Institute of Medical Microbiology, University Hospital Essen, University-Duisburg Essen, Essen, Germany
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University-Duisburg Essen, 45147, Essen, Germany
| | - Sebastian Dolff
- Department of Infectious Diseases, University Hospital Essen, University-Duisburg Essen, Essen, Germany
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