Comamonas Acidovorans Peritonitis in a CAPD Patient Managed with Preservation of the Catheter / 대한신장학회잡지

ABSTRACT

To date, only one case of peritonitis with exit site infection in peritoneal dialysis caused by this micro- organism has been reported. In spite of its apparently benign clinical course, which distinguished it from peritonitis caused by Pseudomonas, this peritonitis relapsed and Comamonas could not be eliminated from the peritoneal liquid, probably due to the persistence of the micro-organism in the exit site. Consequently, peritoneal catheter was removed. In this case, a 68-year-old man was admitted with fever, abdominal tenderness and cloudy peritoneal effluent and empirically treated with antibiotics(cefazolin, tobramycin), intraperitoneally(IP) for 7 days. The first culture was positive for Comamonas acidovorans, sensitive to ceftazidime, cefotetan, ceftriaxone, ciprofloxaxin and imipenem and the perotoneal effluent remained cloudy after 7 days. He was treated with ceftazidime IP, oral ciprofloxacin and nystatin for 26 days. 4 days after the antibiotics treatment, the patient was asymptomatic and the cell count of peritoneal effluent was 50 WBC/mm3 with negative culture. 25 days after the treatment, the patient remained asymptomatic and with 5 WBC/mm3 in peritoneal effluent. Consequently, We experienced a case of peritonitis due to Comamonas acidovorans in a patient on CAPD without exit site infection and managed with preservation of the catheter.