ABSTRACT
We demonstrate the first reported case of peritoneal dialysis (PD)-related peritonitis with Acinetobacter pittii. Although previous reports have reported the uncommon similar infection in the larger Acinetobacter calcoaceticus-baumannii complex group of organisms, none have particularly focused on A pittii. Furthermore, we present a case of a young man with end-stage renal disease on PD who had a severe infection with A pittii. Although the organism was sensitive to ceftazidime, and despite a 4-week extended course of intraperitoneal antibiotics, the patient had a worsening infection leading to the removal of the PD catheter. Furthermore, the case illustrates the importance of proper sterile technique and hand hygiene, as this may have been the nidus of infection for this case.
Subject(s)
Acinetobacter , Peritoneal Dialysis , Peritonitis , Male , Humans , Anti-Bacterial Agents/therapeutic use , Peritoneal Dialysis/adverse effects , Peritonitis/drug therapy , Peritonitis/etiologyABSTRACT
As emergency medicine physicians, we have formulated an approach to managing patients with a chief complaint of headache that starts with considering the story the patient relays in the context of a wide differential. Here we will describe a case that presented to our emergency department in hopes to broaden your differential. Reversible cerebral vasoconstriction syndrome (RCVS), well described in the neurology literature, is characterized by severe headaches that may or may not be accompanied by neurological symptoms and is definitively diagnosed by diffuse constriction of cerebral arteries on cerebral angiogram. Here we present a case of a patient who presented to the emergency department with intermittent severe persistant headaches and was diagnosed with reversible cerebral vasoconstriction syndrome.
