| A Case of Peritonitis caused by Chryseobacterium meningosepticum in a Patient Treated with Peritoneal Dialysis |
| Hyang Mo Koo, M.D.1, Fa mee Doh, M.D.1, Eun Jin Kim, M.D.1, Ea Wha Kang, M.D.2, Suk Kyun Shin, M.D.2 and Tae Ik Chang, M.D.2 |
Department of Internal Medicine1
Yonsei University College of Medicine, Seoul, Korea, Department of Internal Medicine2
NHIC Ilsan Hospital, Goyangshi, Gyeonggi-do, Korea |
| 증례 : 복막투석 환자에서 발생한 Chryseobacterium meningosepticum 복막염 1예 |
| 구향모1, 도화미1, 김은진1, 강이화2, 신석균2, 장태익2 |
| 연세대학교 의과대학 신장내과1 , 국민건강 보험공단 일산병원 신장내과2 |
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| Abstract |
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Chryseobacterium meningosepticum is rarely encountered as a pathogen causing peritonitis in peritoneal dialysis (PD) patients. We report a case of peritonitis due to Chryseobacterium meningosepticum, which was treated successfully with intraperitoneal (IP) vancomycin and ciprofloxacin, and without PD catheter removal. Peritonitis was developed in a 53-year-old PD patient on the third hospital day. Although empirical IP treatment with cefazolin and tobramycin was initiated and maintained for 3 days, the fever and signs of peritonitis persisted. Antibiotics were changed to cefoperazone/sulbactam, amikacin, and vancomycin due to clinical deterioration. After 3 days of vancomycin use, leukocyte count in PD fluid was less than 100/mm3 and the patient became asymptomatic. On seventh day after the onset of peritonitis, Chryseobacterium meningosepticum was isolated from initial dialysate sample, and this strain was susceptible to ciprofloxacin, piperacillin, and piperacillin/tazobactam. Accordingly, we changed the antibiotics to ciprofloxacin and vancomycin, which were given for the total of 14 days. Even though Chryseobacterium meningosepticum is an uncommon causative organism of peritonitis in PD patients, this report suggests that vancomycin and ciprofloxacin are effective as empiric therapy, and early suspicion and appropriate antimicrobial therapy are crucial to the successful treatment of peritonitis due to Chryseobacterium meningosepticum without catheter removal. |
| Key Words:
Chryseobacterium meningosepticum, Peritonitis, Peritoneal dialysis |
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