title: Vancomycin-related eosinophilic peritonitis.
abstract: Eosinophilic peritonitis (EP) is a well-described complication of peritoneal dialysis and is often associated with either a reaction to a constituent of the dialysis system (tubing, sterilant, or solution) or an underlying bacterial or fungal reaction. EP has also been described in the setting of icodextrin use. We report a case of EP associated with intraperitoneal vancomycin used in the treatment of peritonitis secondary to methicillin-resistant Staphylococcus epidermidis. Causation was based upon temporal association, negative cultures, concomitant peripheral eosinophilia, and resolution with cessation of vancomycin. Vancomycin allergy should be considered in the differential diagnosis of EP in the right clinical context. Negative bacterial and fungal cultures are essential to exclude other etiologies.
authors.affiliation: Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia, USA. mhr9r@virginia.edu
authors.forename: Mitchell H
authors.initials: MH
authors.lastname: Rosner
authors.forename: Bed
authors.initials: B
authors.lastname: Chhatkuli
mesh_terms: D000081:Acetamides / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004802:Eosinophilia / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal; D000069349:Linezolid; D016106:Methicillin Resistance; D008875:Middle Aged; D023303:Oxazolidinones / Q000627:therapeutic use; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010538:Peritonitis / Q000139:chemically induced* / Q000188:drug therapy / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy; D013212:Staphylococcus epidermidis / Q000187:drug effects; D014640:Vancomycin / Q000009:adverse effects*
chemical_list: D000081:Acetamides; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D014640:Vancomycin; D000069349:Linezolid