title: Peritonitis caused by Haemophilus parainfluenzae, Leifsonia aquatica, and Gordonia spp. in a patient undergoing continuous ambulatory peritoneal dialysis.
abstract: BACKGROUND
  Peritonitis has remained the most common serious complication of continuous ambulatory peritoneal dialysis (CAPD). In most cases, these infections are monomicrobial, and the pathogens involved most commonly are Staphylococci. Recently, polymicrobial infections with rare organisms have been reported more often.
  
  
  METHODS
  We describe a patient who developed recurrent episodes of CAPD-associated peritonitis with a total of four pathogens: Methicillin-resistant S. aureus, Haemophilus parainfluenzae, Leifsonia aquatica, and Gordonia spp. The infection most likely was acquired when the patient used tap water for dialysis during a camping trip. All episodes were treated successfully with antibiotics. Finally, the device was removed, and later, a new catheter was implanted, which still is in use.
  
  
  CONCLUSIONS
  Peritoneal dialysis-associated peritonitis may be caused by rare organisms. Antibiotics may be able to treat disease temporarily, but removal of contaminated catheters usually is required.
authors.affiliation: Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, USA.
authors.forename: Jason C
authors.initials: JC
authors.lastname: Gardenier
authors.forename: Robert G
authors.initials: RG
authors.lastname: Sawyer
authors.forename: Costi D
authors.initials: CD
authors.lastname: Sifri
authors.forename: Kenneth
authors.initials: K
authors.lastname: Brayman
authors.forename: Brian
authors.initials: B
authors.lastname: Wispelway
authors.forename: Hugo
authors.initials: H
authors.lastname: Bonatti
mesh_terms: D000192:Actinomycetales / Q000302:isolation & purification; D000193:Actinomycetales Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006192:Haemophilus Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D044135:Haemophilus parainfluenzae / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents