Unusual CAPD Citrobacter freundii Peritonitis Complicated by a Fungal Infection, Identified by 16s Ribosomal RNA Gene Sequencing.
10.3904/kjm.2015.88.5.593
- Author:
Tae Ryom OH
1
;
Seong Kwon MA
;
Soo Wan KIM
Author Information
1. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. skimw@chonnam.ac.kr
- Publication Type:Case Report
- Keywords:
Continuous ambulatory peritoneal dialysis;
Citrobacter;
Peritonitis
- MeSH:
Abdominal Abscess;
Abdominal Pain;
Abscess;
Adult;
Bacteria;
Candida tropicalis;
Catheters;
Catheters, Indwelling;
Citrobacter;
Citrobacter freundii*;
Drainage;
Female;
Fever;
Follow-Up Studies;
Humans;
Peritoneal Dialysis;
Peritoneal Dialysis, Continuous Ambulatory*;
Peritonitis*;
Prognosis;
RNA;
RNA, Ribosomal, 16S*;
Sequence Analysis, DNA
- From:Korean Journal of Medicine
2015;88(5):593-597
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We present a case of continuous ambulatory peritoneal dialysis peritonitis caused by Citrobacter freundii complicated by a fungal infection with abscess formation. A 34-year-old woman was admitted to our hospital with abdominal pain. Isolate cultures were confirmed as Citrobacter freundii by DNA sequencing of the 16s ribosomal ribonucleic acid (RNA). Antibiotic therapy was ineffective and Candida tropicalis was isolated in follow-up blood cultures. We administered an antifungal agent and removed the peritoneal catheter. A sudden fever developed, and abdominal computed tomography showed intra-abdominal abscesses. Percutaneous drainage was performed, but no bacteria were cultured. After draining the abscesses, the patient recovered. Citrobacter species are unusual pathogens in peritonitis, and fungal peritonitis is a serious complication of bacterial peritonitis. Indwelling catheters should be removed and appropriate antibiotic therapy provided. Suspicion of a fungal infection combined with bacterial peritonitis will improve the prognosis of patients on peritoneal dialysis.
