Development of Acute Peritonitis after Gynecological Procedure in a Peritoneal Dialysis Patient

Abstract

Although the majority of peritonitis cases in peritoneal (PD) dialysis patients are caused by gram-positive cocci, streptococcus agalactiae, a gram-positive group B  haemoliticus streptococcus, may rarely be found in this group of patients. We present a case of acute peritonitis caused by streptococcus agalactiae with bacteriemia and septic shock occurring after a curettage indicated because of gynecologic bleeding. The patient did not receive antimicrobial prophylaxis since the gynecologist considered this case as a "routine" procedure without the need to administer antibiotics. Our case demonstrate that small procedures may cause great problems and therefore one should always give priority to individual approach regardless of the protocol for "routine" surgery, especially if there are no indications for the emergency procedure.