A case report of Mycobacterium abscessus peritonitis in a peritoneal dialysis patient.
Peritonitis due to nontuberculous mycobacterium in peritoneal dialysis (PD) patients is rare. However, when it occurs, PD catheter removal is required in most cases because of resistance to antibiotic therapy. We report a case of Mycobacterium abscessus peritonitis subsequent to tunnel infection after PD catheter-replacement surgery. The patient underwent this surgery as her tunnel infection had not resolved following the usual 3 month course of antibiotic therapy. After surgery, tunnel infection of the second catheter and peritonitis occurred. Nontuberculous mycobacteria were detected on acid-fast stain from both the old and new exit-site drainage and the peritoneal effluent. The mycobacteria were identified as M. abscessus. Removal of the new catheter and surgical excision of the previous catheter tunnel were performed and multiple antibiotics were started. After 3 months the postsurgical wounds had healed completely. This case demonstrates the importance of further evaluation of unidentified PD catheter-related infections, including an examination for nontuberculous mycobacterium.
Kameyama
Hisako
H
Division of Cardiology and Nephrology, Department of Internal Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan. hisako-k@koto.kpu.m.ac.jp
Mori
Yasukiyo
Y
Kimura
Taiko
T
Sugishita
Chikako
C
Adachi
Takaomi
T
Sonomura
Kazuhiro
K
Kusaba
Tetsuro
T
Tanda
Shuji
S
Kishimoto
Noriko
N
Okigaki
Mitsuhiko
M
Hatta
Tsuguru
T
Matsubara
Hiroaki
H
D000005:Abdomen / Q000473:pathology; D000038:Abscess / Q000150:complications / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000150:complications / Q000209:etiology*; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000150:complications / Q000209:etiology*; D014057:Tomography, X-Ray Computed