Cases reported "Peritonitis"

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1/10. mycobacterium fortuitum peritonitis in two patients receiving continuous ambulatory peritoneal dialysis.

    We present two cases of non-resolving peritonitis treated with a standard peritonitis protocol. The organism identified from the peritoneal effluent was mycobacterium fortuitum, a group IV (Runyon's classification) rapidly growing, nontuberculous mycobacterium. M. fortuitum is ubiquitous and can be isolated from a number of natural sources. risk factors these two patients had for developing M. fortuitum peritonitis included underdialysis, the immunocompromised state associated with end stage renal disease, prior or prolonged broad spectrum antibiotic treatment, and possible exposure to environmental factors, since both were hospitalized at about the same time. The isolates were resistant to the conventional antibiotics recommended for the treatment of this mycobacterium. Both patients, however, responded to catheter removal and antibiotics administered according to the sensitivities of the mycobacterium isolated. copyright copyright 1999 S. Karger AG, Basel
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2/10. Non tuberculous mycobacterium peritonitis in continuous ambulatory peritoneal dialysis.

    A forty-five-year old Saudi lady who had been on Continuous Ambulatory peritoneal dialysis (CAPD) for three years, was admitted with a clinical picture of night fever, sweating, weight loss and turbid peritoneal fluid (PF). The PF had a high cell count, predominantly neutrophils. This condition failed to respond to a standard vancomycin-gentamycin treatment, and acid fast bacilli (AFBs) were stained from the PF. The patient was commenced on antituberculous treatment and the Tenckhoff catheter was removed. She was shifted to haemodialysis and recovered fully. Later, the AFBs were identified as a strain of mycobacterium fortuitum.
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3/10. mycobacterium avium complex peritonitis in an AIDS patient.

    mycobacterium avium complex (MAC) frequently disseminates in AIDS patients, where the gastrointestinal tract is a major target organ. While ascites in AIDS patients is common, peritonitis secondary to MAC is rare. We describe the first case of MAC peritonitis in an AIDS patient without underlying cirrhosis, portal hypertension, chylous ascites or peritoneal dialysis. This case highlights the need to be aware of atypical presentations of MAC disease in AIDS patients with a history of disseminated MAC, even those who compliantly take highly active antiretroviral therapy.
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keywords = avium
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4/10. Mycobacterial peritonitis in pediatric peritoneal dialysis patients.

    peritonitis is the most common complication and the leading cause of death in pediatric peritoneal dialysis (PD) patients. According to the most recent data available from the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS), approximately 25% of pediatric PD patients who die succumb to infection. There are no reported cases of mycobacterium tuberculosis (MTB) or Mycobacterium avium-intracellulare peritonitis in the NAPRTCS registry. With an increasing incidence of MTB worldwide and the impairment of cellular immunity in chronic renal failure patients, it is not surprising that mycobacterium peritonitis can occur in PD patients. We report two pediatric PD patients with mycobacterial peritoneal infection diagnosed over an 11-year period at our institution. One patient presented with a malfunctioning Tenckhoff catheter and again 3 years later with hyponatremia and ascites. The other presented with recurrent culture-negative peritonitis. These cases illustrate the importance of more extensive evaluation of PD complications, to include evaluation for mycobacterium with special media or peritoneal biopsy, in the above clinical settings if the routine work-up is unrevealing.
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keywords = mycobacterium, avium
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5/10. mycobacterium avium complex peritonitis in the setting of cirrhosis: case report and review of the literature.

    mycobacterium avium complex is a rare cause of peritonitis. We report here the fourth case in the literature of MAC peritonitis associated with cirrhosis in the absence of AIDS, and discuss the possibility of different etiologies in persons with and without AIDS.
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6/10. Mycobacterium simiae: a previously undescribed pathogen in peritoneal dialysis peritonitis.

    peritonitis is a major complication of peritoneal dialysis (PD). coagulase-negative staphylococcus, staphylococcus aureus , and gram-negative bacteria cause the majority of these infections and usually are amenable to conventional antibiotic therapy, allowing continuation of PD. Mycobacterial and fungal peritonitis represent a more difficult clinical challenge. The infecting organism is often difficult to isolate and can rarely be eradicated without catheter removal. Immunocompromised patients are susceptible to opportunistic infection and, in the context of PD, may have PD peritonitis with different organisms from immunocompetent patients. Here the authors report for the first time PD peritonitis caused by Mycobacterium simiae , a nontuberculous mycobacterium, in a human immunodeficiency virus-positive patient. In addition the difficulty in diagnosing and managing nontuberculous PD peritonitis is discussed.
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keywords = mycobacterium
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7/10. mycobacterium fortuitum peritonitis in a patient undergoing chronic peritoneal dialysis.

    peritonitis, due to mycobacterium fortuitum, developed in a 15-yr-old young man undergoing chronic peritoneal dialysis. Although of low pathogenic potential, this rapidly growing non-tuberculous mycobacterium does cause human disease particularly in the compromised host and should be considered as a potential cause of peritonitis in the chronic peritoneal dialysis patient.
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8/10. Nontuberculous mycobacterial peritonitis associated with continuous ambulatory peritoneal dialysis.

    We report two patients undergoing continuous ambulatory peritoneal dialysis (CAPD) in whom peritonitis developed and nontuberculous mycobacteria were isolated from peritoneal fluid. In one, Mycobacterium avium-intracellularis was the only organism isolated. Despite a three-month course of antibiotics to which the organism showed in vitro sensitivity, there was no apparent response. The patient died, and an autopsy showed disseminated mycobacterial disease. In the second case, mycobacterium fortuitum and diphtheroids were isolated from the peritoneal fluid. Although it was not clear that the mycobacterium was solely responsible for the peritonitis in the second case, the infection failed to resolve with antibiotic therapy appropriate for diphtheroids. This patient also died. Both patients had indolent, chronic infections, although there was granulocyte predominance in the peritoneal fluid. Both had involvement of the catheter exit site. To our knowledge, these are the first reported cases of nontuberculous mycobacterial peritonitis in CAPD patients. We recommend evaluation for mycobacteria, including cultures and stains of dialysate specimens, in all cases of CAPD-associated peritonitis where no organism is identified, or where no improvement is noted after 48 hours of therapy. Repeated cultures for mycobacteria are appropriate for suggestive cases. Since these infections are difficult to treat, it may be prudent to remove the dialysis catheter if they are isolated.
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ranking = 0.35258902750036
keywords = mycobacterium, avium
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9/10. peritonitis associated with disseminated mycobacterium avium complex in an acquired immunodeficiency syndrome patient on chronic ambulatory peritoneal dialysis.

    Chronic ambulatory peritoneal dialysis (CAPD) is a commonly used form of renal replacement therapy in patients with end-stage renal disease (ESRD) infected with the human immunodeficiency virus (hiv). An increased incidence of peritonitis, as well as an increased rate of infections with unusual and serious organisms, has been reported in these patients. We report the first case of an hiv-infected patient who developed clinical peritonitis associated with Mycobacterium avium-intracellulare (MAI) infection. We suggest that the diagnosis of MAI peritonitis be suspected in hiv-infected patients with clinical CAPD peritonitis, negative cultures for bacteria or fungi, and a CD4 count less than 100 cells/microL. Therapy with a two-drug regimen for disseminated MAI infection without removal of the peritoneal dialysis (PD) catheter appears to provide symptomatic improvement while allowing ongoing PD.
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keywords = avium
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10/10. Failure to cure Mycobacterium gordonae peritonitis associated with continuous ambulatory peritoneal dialysis.

    nontuberculous mycobacteria are increasingly recognized as important pathogens in peritonitis associated with continuous ambulatory peritoneal dialysis (CAPD). Mycobacterium gordonae rarely causes human infection and is the least likely mycobacterium to produce clinical infection in CAPD patients. We describe a patient with persistent M. gordonae peritonitis acquired while undergoing CAPD. During 18 months of treatment, clinical improvement occurred but a microbiological cure could not be achieved. Principles of therapy for mycobacterial peritonitis developing during CAPD are reviewed, and potential explanations for our patient's failure to respond to therapy are discussed.
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