title: Rhodococcus equi peritonitis in continuous ambulatory peritoneal dialysis: a first in Australia.
abstract: A 33-year-old Caucasian man with end-stage renal disease secondary to biopsy-proven IgA nephropathy, managed with continuous ambulatory peritoneal dialysis (PD), presented with PD-related peritonitis, the causal organism being a non-branching Gram-positive bacillus, Rhodococcus equi. Initial empirical Gram positive and negative coverage with cefazolin and ceftazidime was unsuccessful, but following isolation of the organism, and conversion to intraperitoneal vancomycin and oral ciprofloxacin, the peritonitis episode resolved. At day 10, vancomycin was switched to azithromycin for a total of 6 weeks of antimicrobial therapy. The PD catheter was preserved, and the patient remained peritonitis-free at 6 months of follow-up.
authors.affiliation: Department of Nephrology, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.
authors.forename: Omar
authors.initials: O
authors.lastname: Azzam
authors.affiliation: Department of Microbiology, Royal Darwin Hospital, Alice Springs, Northern Territory, Australia.
authors.forename: Amy
authors.initials: A
authors.lastname: Crowe
authors.affiliation: Alice Springs Hospital, Alice Springs, Northern Territory, Australia.
authors.forename: Cherian
authors.initials: C
authors.lastname: Sajiv
authors.affiliation: Department of Nephrology, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.
authors.forename: Basant
authors.initials: B
authors.lastname: Pawar
mesh_terms: D000193:Actinomycetales Infections / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D001315:Australia; D017963:Azithromycin / Q000008:administration & dosage; D002939:Ciprofloxacin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D016929:Rhodococcus equi / Q000302:isolation & purification*; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D014640:Vancomycin; D017963:Azithromycin