title: Enteric peritonitis caused by Clostridium perfringens in peritoneal dialysis.
abstract: Peritonitis is a common complication in peritoneal dialysis (PD). Epidemiology of the causative organism varied over time, but anaerobes are still extremely rare. We describe a second reported case of Clostridium perfringens peritonitis in a peritoneal dialysis patient since 1998. The patient presented with PD-related peritonitis that did not respond to the antibiotic choice recommended by the International Society of Peritoneal Dialysis guidelines. We used piperacillin/tazobactam with good result, when the dialysate culture revealed a gram-positive anaerobe. We postulate that Clostridium perfringen came from an enteric source by translocation. A few studies have implicated diverticular disease and gastric acid inhibitors in PD-related enteric peritonitis, and the results are still controversial. Further study is needed to establish a correlation between bowel pathology and enteric peritonitis in peritoneal dialysis patients.
authors.affiliation: Hospital of Saint Raphael, New Haven, USA.
authors.forename: Vimon
authors.initials: V
authors.lastname: Seriburi
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Reynolds
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018988:Bacterial Translocation; D003015:Clostridium Infections / Q000209:etiology*; D003016:Clostridium perfringens; D006801:Humans; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000209:etiology*