[Capnocytophaga spp. peritonitis in a peritoneal dialysis: A case report]. / Péritonite à Capnocytophaga spp. en dialyse péritonéale automatisée : à propos d'un cas.

INTRODUCTION: Capnocytophaga spp. is a slow-growing bacterium that forms a part of the normal oral flora of dogs and cats. In peritoneal dialysis, only seven cases have been reported. We report the observation of a case of peritonitis with Capnocytophaga spp. in a patient on peritoneal dialysis who lives with a cat. CASE REPORT: A 64-year-old woman with chronic end stage renal disease due to chronic interstitial nephropathy on automated peritoneal dialysis has been admitted for diffuse abdominal pain. The dialysis fluid was cloudy with 11,250 elements/mm3, of leukocytes. Direct examination was negative. The C-reactive protein was 165mg/L. Intraperitoneal probabilistic antibiotic therapy was initiated 1g of cefazolin and 1g of ceftazidime per day. After eight days, aerobic culture was negative, the anaerobic one was positive to gram negative bacilli, but the identification could not be possible with MALDI-TOF mass spectrometry. Antibiotic therapy was continued by ceftazidime for 21 days. The evolution was marked by the improvement of the clinical and biological state of the patient. The germ was finally identified using the genomic 16S rRNA sequencing technique. This is Capnocytophaga spp. Investigation then revealed that the patient's cat sometimes entered her room at the time of connection of peritoneal dialysis. CONCLUSION: The case of our patient once again reveals the diagnostic difficulties posed by Capnocytophaga spp. Innovative techniques, such as MALDI-TOF-MS or genomic sequencing of ribosomal RNA, should be further used in peritoneal dialysis in the diagnosis of peritonitis.

[Lyme nephritis in humans: Physio-pathological bases and spectrum of kidney lesions]. / La néphrite de Lyme chez l'homme : bases physiopathologiques et spectre lésionnel rénal.

Known in less than half a century, borreliosis, or Lyme disease, is a zoonosis caused by the tick bite. It is the most common vector disease in Europe and the United States. Borrelia burgdorferi sensu lato, the bacterium in question, is fitted with a "cunning device" that allows it to trick the immune system and implant the infection chronically. It causes multi-system tissue damage mediated by the inflammatory response of the host. Renal involvement is rarely reported and is better known in dogs as Lyme nephritis. The first case of kidney impairment in the human being was described in 1999, and since then eight other cases have been reported. The involvement is preferentially glomerular; the histological forms vary between immune complex nephropathy and podocytopathy. The pathophysiological mechanisms appear to be triple: immune complex deposits, podocytic hyper-expression of the B7-1 membrane protein, and renal infiltration of inflammatory cells. On the basis of the accumulated knowledge of the disease in just over 40 years, this review aims at establishing the physio-pathological hypotheses of renal involvement in order to better define the histological lesions.