Mycobacterium fortuitum peritonitis in two patients receiving continuous ambulatory peritoneal dialysis.
We present two cases of non-resolving peritonitis treated with a standard peritonitis protocol. The organism identified from the peritoneal effluent was Mycobacterium fortuitum, a group IV (Runyon's classification) rapidly growing, nontuberculous mycobacterium. M. fortuitum is ubiquitous and can be isolated from a number of natural sources. Risk factors these two patients had for developing M. fortuitum peritonitis included underdialysis, the immunocompromised state associated with end stage renal disease, prior or prolonged broad spectrum antibiotic treatment, and possible exposure to environmental factors, since both were hospitalized at about the same time. The isolates were resistant to the conventional antibiotics recommended for the treatment of this mycobacterium. Both patients, however, responded to catheter removal and antibiotics administered according to the sensitivities of the mycobacterium isolated.
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Division of Renal Diseases and Hypertension, Department of Medicine, The George Washington University Medical Center, Washington, DC, USA.
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D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents; D001202:Ascitic Fluid / Q000382:microbiology*; D003428:Cross Infection / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D019907:Mycobacterium fortuitum / Q000302:isolation & purification*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D051437:Renal Insufficiency / Q000628:therapy
D000900:Anti-Bacterial Agents