title: A case report of Mycobacterium abscessus peritonitis in a peritoneal dialysis patient.
abstract: 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.
authors.affiliation: Division of Cardiology and Nephrology, Department of Internal Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan. hisako-k@koto.kpu.m.ac.jp
authors.forename: Hisako
authors.initials: H
authors.lastname: Kameyama
authors.forename: Yasukiyo
authors.initials: Y
authors.lastname: Mori
authors.forename: Taiko
authors.initials: T
authors.lastname: Kimura
authors.forename: Chikako
authors.initials: C
authors.lastname: Sugishita
authors.forename: Takaomi
authors.initials: T
authors.lastname: Adachi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sonomura
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kusaba
authors.forename: Shuji
authors.initials: S
authors.lastname: Tanda
authors.forename: Noriko
authors.initials: N
authors.lastname: Kishimoto
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Okigaki
authors.forename: Tsuguru
authors.initials: T
authors.lastname: Hatta
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsubara
mesh_terms: 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