Abstract
A 67-year-old woman on continuous ambulatory peritoneal dialysis (CAPD) developed peritonitis due to Mycobacterium fortuitum. Reinsertion of a CAPD catheter, injection of urokinase and heparin into the new catheter were performed. Oral levofroxacin treatment was also continued for 2 months. After such therapy, the cloudy CAPD fluid became clear. However, peritonitis due to the same Mycobacterium relapsed within one week and the culture of dialysate remained positive despite the antibiotic therapy. The catheter was therefore removed. Thereafter, the patient presented sclerosing encapsulated peritonitis-like symptoms for 2-3 months because of severely prolonged peritonitis. It appears that the removal of CAPD catheter is the most appropriate method of eradicating Mycobacterium fortuitum-induced peritonitis, especially in patients who do not respond to antimicrobial therapy.
