title: Peritonitis due to Neisseria mucosa in an adolescent receiving peritoneal dialysis.
abstract: Neisseria mucosa is part of the normal nasopharyngeal flora and rarely pathogenic in humans. Reports of serious infections associated with this pathogen are very unusual. A 17-year-old boy with end-stage renal disease due to IgA nephropathy presented with acute, spontaneous, symptomatic peritoneal dialysis-associated peritonitis without reported break in sterility or PD catheter exit site infection. beta-lactamase-negative N. mucosa was isolated from the dialysate effluent. Intraperitoneal antibiotic treatment with cephalothin/gentamicin for 5 days and subsequent ceftriaxone led to complete resolution of the infection. This case demonstrates that "non-pathogenic" Neisseria species can cause clinically severe peritonitis with high intraperitoneal neutrophil counts, elevated C-reactive protein levels in the peritoneal effluent (in the presented case, 27,600/mul and 3.6 mg/l, respectively) and impaired peritoneal membrane transport function. To our knowledge, this is the first case of N. mucosa peritonitis complicating chronic peritoneal dialysis in an adolescent patient.
authors.affiliation: Department of Pediatrics, Wake Forest University Health Sciences, and Brenner Children's Hospital, Winston-Salem, North Carolina, USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Shetty
authors.forename: S K
authors.initials: SK
authors.lastname: Nagaraj
authors.forename: W B
authors.initials: WB
authors.lastname: Lorentz
authors.forename: M
authors.initials: M
authors.lastname: Bitzan
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology; D002443:Ceftriaxone / Q000008:administration & dosage / Q000494:pharmacology; D002512:Cephalothin / Q000008:administration & dosage / Q000494:pharmacology; D005839:Gentamicins / Q000008:administration & dosage / Q000494:pharmacology; D005922:Glomerulonephritis, IGA / Q000150:complications*; D006801:Humans; D007274:Injections, Intraperitoneal; D008297:Male; D042807:Neisseria mucosa / Q000302:isolation & purification*; D016870:Neisseriaceae Infections / Q000382:microbiology*; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002443:Ceftriaxone; D002512:Cephalothin