Revista de prevención y atención de la salud

Abstracto

Successful treatment of CAPD peritonitis caused by Moraxella catarrhalis

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Introduction: Peritoneal dialysis (PD) as a treatment method for end-stage renal disease (ESRD), complementary to hemodialysis (HD) and renal transplantation, is based on simultaneous daily exchange through a peritoneal catheter. One of the main complications of this home dialysis method is peritonitis. According to a report by the International Society of Peritoneal Dialysis, fatal outcome was reported in less than 5% of total peritonitis episodes, but indirectly caused nearly 18% of episodes. The main culprits are saprophytic gram-positive microorganisms originating from the skin. Here we report an unusual case of peritonitis due to Moraxella catarrhalis. According to the relevant literature data, there were only 8 reported cases of peritonitis due to this pathogen before my article. Case report: A 59-year-old man on peritoneal dialysis for diabetic nephropathy was admitted to our hospital due to CAPD peritonitis. After initial empirical treatment and the absence of positive therapeutic results, we have considered removing the PD catheter and urgently transferring him to HD due to the refractory form. On the fifth day after admission, we have obtained the result of an additional identification performed in the meantime with the isolation of this rare cause. After antibiotic susceptibility testing, we completely changed our therapeutic approach and after two weeks of antibiotic treatment we have achieved a complete recovery. Conclusions: Peritonitis remains one of the most serious complications of peritoneal dialysis. Accurate and rapid identification of the causative organism, together with the prior initiation of appropriate empirical treatment that can cover most causes, is necessary for a positive outcome of this complication. In the absence of an initial positive therapeutic result, we screened for rare causes in order to place a rescue catheter and this ESRD modality.