Lactobacillus peritonitis: a rare cause of peritonitis in peritoneal dialysis patients.
Lactobacilli are part of the normal gastrointestinal and female genitourinary flora in humans and they are seldom pathogenic and rarely cause human disease. In the literature, Lactobacillus peritonitis was most common in immunocompromised patients, including patients under chronic peritoneal dialysis. We also suspect that the presence of Lactobacillus spp. in the peritoneal fluid might indicate the leakage of normal flora from a perforated intraabdominal hollow organ. To access the versatile clinical pictures of Lactobacillus peritonitis, this investigation retrospectively reviewed the medical records for Lactobacillus spp. isolated from peritoneal fluid from July 1998 to January 2002 at Chang-Gung Memorial Hospital, Taipei, Taiwan. A total of 10 patients were enrolled in the study. Six of these 10 patients had concomitant intraabdominal hollow organ perforation, and peritoneal fluid cultures in these six patients also contained bacteria other than Lactobacillus spp. All six patients had recently experienced either abdominal surgery or blunt abdominal trauma. The remaining four patients who had not undergone surgery had decompensated liver cirrhosis with ascites and spontaneous bacterial peritonitis. The results suggested that the presence of Lactobacillus spp. in the peritoneal fluid other than immunocompromised patients should raise the suspicion of hollow organ perforation in patients with recent abdominal surgery or blunt abdominal trauma.
Department of Nephrology, Chang-Gung Memorial Hospital, Taipei, Taiwan.
Shen-Yang
SY
Lee
Chiz-Tzung
CT
Chang
Ming-Hsun
MH
Lee
Mai-Szu
MS
Wu
D034841:Abdominal Cavity / Q000601:surgery; D000007:Abdominal Injuries / Q000150:complications; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001202:Ascitic Fluid / Q000382:microbiology*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000209:etiology*; D006801:Humans; D007778:Lactobacillus / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000382:microbiology*; D012189:Retrospective Studies; D012307:Risk Factors