01716nas a2200181   4500000000100000008004100001260001700042100001300059700001500072700001400087700001400101245012700115250001500242300000700257490000700264520121700271020004601488       2012                            d  c-357895455641 aJiang S.1 aRoberts D.1 aDawson A.1 aJardine M00aMycobacterium fortuitum as a cause of peritoneal dialysis-associated peritonitis: case report and review of the literature  a2012/06/12  a350 v133 a<p>
ABSTRACT: BACKGROUND: Peritoneal dialysis-associated peritonitis (PD-peritonitis) due to Mycobacterium spp is uncommon. Non-tuberculous Mycobacterium (NTB) PD-peritonitis can present in a similar fashion to more common causes of bacterial PD-peritonitis. We describe the first reported case of multiresistant Mycobacterium fortuitum PD-peritonitis in an Australian patient. CASE PRESENTATION: A 38 year-old woman developed mild PD-peritonitis during an overseas holiday. Treatment was complicated by delayed diagnosis, requirement for special investigations, treatment with multiple antibiotics, and conversion to haemodialysis following removal of her Tenckhoff catheter. CONCLUSION: This case demonstrates the diagnostic yield of pursuing further investigations in cases of initially culture-negative, problematic PD-peritonitis. A systematic review of the literature identified only 17 reports of M. fortuitum PD-peritonitis. Similar to our case, a delay in microbiological diagnosis was frequently noted and the Tenckhoff catheter was commonly removed at the time of diagnosis. The type and duration of antibiotic therapy also varied widely so the optimum treatment appears to be poorly defined.
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