Polymicrobial peritonitis case in a patient who underwent continuous ambulatory peritoneal dialysis result with exitus

Yıl 2020, , 258 - 261, 01.06.2020

Taliha Karakök , Ayşe Büyükdemirci , Salih Cesur , Salim Tece Sami Kınıklı , Gül Gürsoy

https://doi.org/10.21601/ortadogutipdergisi.612118

Öz

Peritonitis is a common complication in patients undergoing continuous ambulatory peritoneal dialysis. Majority of cases are usually due to a single agent. Besides, polymicrobial peritonitis develops in approximately 1-4% of patients. A gram-negative pathogen with another bacteria or fungus and rarely more than one gram- positive pathogen are responsible for this polymicrobial peritonitis. It is recommended to investigate intraabdominal focus in patients with polymicrobial peritonitis. In this article, we present a 29-year-old patient with chronic renal disease for 7 years who underwent continuous ambulatory peritoneal dialysis for the last 1 year and had polymicrobial peritonitis due to Serratia fonticola, Enterococcus faecium and Cryptococcus laurenti and resulted with exitus.

Anahtar Kelimeler

Polymicrobial peritonitis, Serratia fonticola, Enteroccus faeicum, Cryptococcus laurenti

Sürekli ayaktan periton diyalizi uygulanan bir hastada mortal seyreden polimikrobiyal peritonit

Öz

Peritonit, sürekli ayaktan periton diyalizi uygulanan hastalarda sık görülen bir komplikasyondur ve vakaların çoğunluğunda genellikle tek bir etkene bağlı olarak gelişir. Bununla birlikte, hastaların yaklaşık %1-4’ünde polimikrobiyal peritonit gelişmektedir. Bu hastaların çoğunda gram negatif bir etken ile birlikte mantarlar, nadiren de birden fazla gram pozitif patojen rapor edilmektedir. Polimikrobiyal peritonit gelişen olgularda intraabdominal odak araştırılması önerilmektedir. Bu yazıda 29 yaşında 7 senedir kronik böbrek hastalığı olan ve son bir senedir sürekli ayaktan periton diyalizi uygulanan periton kültüründe Serratia fonticola, Enteroccus faeicum ve Criptococcus laurenti üreyen ve mortal seyreden bir hasta sunuldu.

Anahtar Kelimeler

Polimikrobiyal peritonit, Serratia fonticola, Enteroccus faeicum, Cryptococcus laurenti

Kaynakça

• Mocan H, Murphy AV, Beattie TJ, McAllister TA. Fungal peritonitis in children on continuous ambulatory peritoneal dialysis. Scottish Med J 1989; 34: 494-6.
• Szeto CC, Chow KM, Wong TYH, Leung CB, Li PKT. Conservative management of polymicrobial peritonitis complicating peritoneal dialysis—a series of 140 consecutive cases. Am J Med 2002; 113: 728-33.
• Gavini F, Ferragut C, Izard D, ve ark. Serratia fonticola, a new species from water. Int J Systematic Evolutionary Microbiol 1979; 29: 92-101.
• Müller HE, Steigerwalt AG, Brenner DJ. Isolation of Serratia fonticola from birds. Zentralblatt für Bakteriologie, Mikrobiologie und Hygiene. Series A: Medical Microbiology, Infectious Diseases, Virology, Parasitology 1986; 261: 212-8.
• Bollet C, Gainnier M, Sainty JM, Orhesser P, De Micco P. Serratia fonticola isolated from a leg abscess. J Clin Microbiol 1991; 29: 834.
• Aljorayid A, Viau R, Castellino L, Jump RL. Serratia fonticola, pathogen or bystander? A case series and review of the literature. IDCases 2016; 5: 6-8.
• Li PKT, Szeto CC, Piraino B, et al. ISPD peritonitis recommendations: 2016 update on prevention and treatment. Peritoneal Dialysis Int 2016; 36: 481-508.
• Kordossis T, Avlami A, Velegraki A, ve ark. First report of Cryptococcus laurentii meningitis and a fatal case of Cryptococcus albidus cryptococcaemia in AIDS patients. Medical Mycology 1998; 36: 335-9.
• Bhat V, Vira H, Khattry N, Toshniwal M. Cryptococcus laurentii diarrhea post hematopoietic stem cell transplant. Transplant Infect Dis 2017; 19 e12663.
• Averbuch D, Boekhout T, Falk R, ve ark. Fungemia in a cancer patient caused by fluconazole-resistant Cryptococcus laurentii. Medical Mycology 2002; 40: 479-84.
• Kamalam A, Yesudian P, Thambiah AS. Cutaneous infection by Cryptococcus laurentii. British J Dermatol 1977; 97: 221-3.
• Asano M, Mizutani M, Nagahara Y, ve ark. Successful treatment of Cryptococcus laurentii peritonitis in a patient on peritoneal dialysis. Int Med 2015; 54: 941-4.
• Sinnott IV JT, Rodnite J, Emmanuel PJ, Compos A. Cryptococcus laurentii infection complicating peritoneal dialysis. Pediatric Infect Dis J 1989; 8: 803-4.