2022 Volume 71 Issue 3 Pages 587-593
Peritonitis is a frequent complication of peritoneal dialysis (PD). Common etiologic agents are staphylococcal species, whereas infections caused by rapidly growing mycobacteria (RGM) are considered rare. We report here a case of PD-associated peritonitis caused by RGM, specifically Mycobacterium mageritense. The patient, a woman in her 60s undergoing continuous ambulatory peritoneal dialysis (CAPD), was admitted to our hospital because of persistent diarrhea and general malaise, leading to the suspicion of PD-associated peritonitis. CAPD drainage fluid was collected and cultured in a blood culture bottle for 42 h. Ziehl–Neelsen staining showed the presence of acid-fast bacilli. The colonies formed were further analyzed and identified as M. mageritense by mass spectometry (MALDI Biotyper). The patient was treated with meropenem (temporarily changed to imipenem/cilastatin) and levofloxacin, and she was discharged after five weeks because her symptoms were better. This case demonstrates the importance of the accurate identification of mycobacterial species and drug susceptibility testing for the appropriate diagnosis and treatment of PD-associated peritonitis.
