Intraperitoneal hydrocortisone in eosinophilic peritonitis associated with continuous ambulatory peritoneal dialysis.

Leung, Allen; Orange, G.; Henderson, I.A.

doi:10.1136/bmj.286.6367.766

Cited by 23 publications

(17 citation statements)

References 1 publication

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“…The paucity of reports of C. jeikeium infections in Great Britain, compared with the United States, may be due to differences in identification procedures (106). Diphtheroids causing peritonitis in five Glasgow patients on chronic ambulatory peritoneal dialysis closely resembled C. jeikeium, although most were less resistant to antimicrobial agents than those described in earlier reports (121).…”

Section: Introductionmentioning

confidence: 94%

Coryneform bacteria in infectious diseases: clinical and laboratory aspects

1990

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Coryneform isolates from clinical specimens frequently cannot be identified by either reference laboratories or research laboratories. Many of these organisms are skin flora that belong to a large number of taxonomic groups, only 40% of which are in the genus Corynebacterium. This review provides an update on clinical presentations, microbiological features, and pathogenic mechanisms of infections with nondiphtheria Corynebacterium species and other pleomorphic gram-positive rods. The early literature is also reviewed for a few coryneforms, especially those whose roles as pathogens are controversial. Recognition of newly emerging opportunistic coryneforms is dependent on sound identification schemes which cannot be developed until cell wall analyses and nucleic acid studies have defined the taxonomic groups and all of the reference strains within each taxon have been shown by molecular methods to be authentic members. Only then can reliable batteries of biochemical tests be selected for distinguishing each taxon.

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Section: Introductionmentioning

confidence: 94%

Coryneform bacteria in infectious diseases: clinical and laboratory aspects

1990

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“…Case reports suggest that a short course of IP-administered hydrocortisone can be effective in resolving the peritoneal eosinophilia [4,9]; however, its effect is not sustained. Ketotifen, a fast-acting non-competitive histamine antagonist, has also been shown in case reports [9] to lead to a sustained decrease in the peritoneal eosinophil count when used at the standard orally administered dosage.…”

Section: Discussionmentioning

confidence: 96%

“…Patients are frequently asymptomatic but can present with turbid peritoneal fluid. The cause is assumed to be hypersensitivity of the peritoneal membrane to the presence of non-physiological challenges; for example, a component of the dialysis system such as the tubing or dialysate bags [4], air in the peritoneum [5], the dialysate itself [6] or intraperitoneally administered (IP) medications [7], including antibiotics.…”

Section: Introductionmentioning

confidence: 99%

Eosinophilic peritonitis in children on chronic peritoneal dialysis

Quinlan¹,

Cantwell²,

Rees³

2009

Pediatr Nephrol

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Eosinophilic peritonitis is a response of the peritoneum to foreign substances. It presents as cloudy dialysate and may be missed because not all laboratories report the eosinophil count, giving only the total number of polymorphonuclear cells. Over a 2-year period, eight children developed 13 episodes of eosinophilic peritonitis. Three episodes were asymptomatic other than cloudy fluid, five followed surgery and two were associated with gastroenteritis. Despite recurrent episodes, there were no adverse outcomes, although a raised peritoneal eosinophil count persisted in most cases. Eosinophilic peritonitis is under-diagnosed and may lead to unnecessary antibiotic therapy.

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“…First, true "aseptic" peritonitis does seem to exist. These patients have high numbers of eosinophils in their peritoneal fluid and respond to steriod therapy (6,10). Second, the sensitivity of the method used to culture the peritoneal fluid may influence organism recovery.…”

Section: Notes 787mentioning

confidence: 99%

Mycobacterium fortuitum peritonitis associated with continuous ambulatory peritoneal dialysis

1986

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Mycobacterium fortuitum has been isolated from skin and soft tissue lesions with increasing frequency. Rarely, however, has it been a documented cause of peritonitis in patients receiving continuous ambulatory peritoneal dialysis. We report here the second such case and discuss both the possibility of M. fortuitum or similar organisms as one cause of "sterile" peritonitis in this patient population and the in vitro antimicrobial susceptibility testing of such isolates. Mycobacterium fortuitum has been isolated as a pathogen from several extrapulmonary sites. There has been, however, only one well-documented case of M. fortuitum causing peritonitis in a patient receiving continuous ambulatory peritoneal dialysis (CAPD) (13). We present here the second such case. The possible role of the organism in culturenegative peritonitis and methods of determining the in vitro antimicrobial susceptibilities of such isolates are discussed. Case report. A 32-year-old male being treated with CAPD for end-stage renal disease and with several medications for various psychiatric problems was admitted on 18 February 1985 with complaints of confusion and visual hallucinations. CAPD had been initiated in July 1984, and since that time the patient had experienced at least four episodes of peritonitis. On two occasions no organisms were cultured; Staphylococcus epidermidis and S. aureus were each cultured during two separate episodes. A physical examination at admission revealed a disoriented, thin male. His blood pressure was 134/90, his pulse was 88 beats per min and regular, and his temperature was 37.5°C. His abdomen was soft, and the catheter site was clean. The peripheral leukocyte count was 5,000/mm3, with a normal differential. The patient improved after psychotropic drugs were stopped, but he remained hospitalized to receive intensive psychotherapy. CAPD was continued. On 28 February 1985, the patient's temperature rose to 38.3°C, and he complained of abdominal pain. The peritoneal fluid was cloudy and contained 3,845 leukocytes per mm3, with 83% polymorphonuclear leukocytes. No organisms were revealed by Gram staining. The peripheral leukocyte count was 8,400 /mm3, with a slight left shift. Vancomycin and rifampin were administered after routine culturing of the peritoneal fluid was done. These cultures yielded no organisms. Fever and abdominal pain persisted, and the peritoneal fluid remained cloudy. The fluid was submitted for routine culturing as well as for culturing for fungi and mycobacteria on 3 March and 5 March. Routine cultures again showed no growth, and Gram staining revealed no organisms. Rifampin was discontinued, and gentamicin was begun. On 8 March, the peritoneal catheter was surgically removed, samples for culturing were taken of peritoneal fluid, peritoneal tissue, and the exit site, and a peritoneal biopsy was obtained. Histologic examination of the latter showed nonspecific chronic inflammation. On 9 March, the fluid submitted 6 days before was reported to be "positive for acid-fast bacilli,

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Intraperitoneal hydrocortisone in eosinophilic peritonitis associated with continuous ambulatory peritoneal dialysis.

Cited by 23 publications

References 1 publication

Coryneform bacteria in infectious diseases: clinical and laboratory aspects

Coryneform bacteria in infectious diseases: clinical and laboratory aspects

Eosinophilic peritonitis in children on chronic peritoneal dialysis

Mycobacterium fortuitum peritonitis associated with continuous ambulatory peritoneal dialysis

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