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నైరూప్య

Successful Treatment Of Capd Peritonitis Caused By Moraxella Catarrhalis

Dejan Pilčević

Introduction: Peritoneal dialysis (PD) as a method of treatment in end stage renal disease (ESRD), complementary to hemodialysis (HD) and kidney transplantation, is based on simultaneous daily exchange via a peritoneal catheter. A major complication of this home dialysis method is peritonitis. According to a report by the International Society for Peritoneal Dialysis, the fatal outcome was reported in less than 5% of total episodes of peritonitis, but indirectly it cause same in nearly 18% of episodes. Leading causers are saprophytic gram-positive microorganisms that originate from the skin. Here I report an unusual case of peritonitis due to Moraxella catarrhalis. Based on relevant literature data, there were only 8 reported cases of peritonitis due to this pathogen prior to my paper. Case Report: A male, 59 age, on peritoneal dialysis modality due to diabetic nephropathy was admitted to our hospital due to CAPD peritonitis. After initial empiric treatment and absence of positive therapeutic result, we have considered extraction of PD catheter and emergency transfer to HD due to refractary form. On the 5th day after admission, we have got result of in meantime conducted additional identification with isolation of this infrequent causer. After antibiotic susceptibility testing, we completely changed our therapeutic approach and after two week antibiotic treatment we have got complete recovery. Conclusions:Peritonitis remains a most serious complication of peritoneal dialysis. Accurate and prompt identification of the causative organism, along with previous starting of appropriate empiric treatment which can cover majority of causers is necessary for positive outcome of this complication. In the absence of initially positive therapeutic result, we have to detect infrequent causers in the purpose of rescue catheter and this ESRD modality.