Introduction: Complications of peritoneal dialysis (PD) such as exit-site infections and PD peritonitis are common reasons for admission to General Internal Medicine wards. Culprit organisms range from typical skin flora to rarer complicated atypical organisms such as non-tuberculous mycobacteria. Encapsulating peritoneal sclerosis (EPS) is a rarer complication of PD characterized by peritoneal inflammation, ileus and fibrosis with high morbidity, few management options, and poor prognosis. Case Description: We report the case of a patient with a history of end-stage renal disease on peritoneal dialysis who presented with undifferentiated peritonitis and ileus refractory to standard antimicrobial therapy. Subsequent ascitic cultures were positive for Mycobacterium abscessus, and CT imaging was consistent with EPS. To date, EPS secondary to M. abscessus peritonitis has not previously been described. Discussion and Conclusion: This report describes the diagnostic process and treatment offered to this patient and his treatment outcomes over 8 months. It highlights the importance of prompt identification of patients at risk, timely eradication of high-risk pathogens, and transition to haemodialysis to limit morbidity and improve patient prognosis.
Implication Statement
An Internal Medicine (IM) specific, near-peer mentorship program was initiated at the University of Ottawa (uOttawa) in 2017. Medical students were paired with IM resident mentors in an effort to improve career decision-making. Additionally, residents had the opportunity to formally teach mentees various high-yield IM topics. Program evaluation was completed using data from three participant cohorts, and showed that the program had a positive impact on students’ career decision making. Given the program’s flexible nature and ease of implementation, it is well suited for adaptation at other institutions.
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