Neisseria elongata–mediated peritonitis in an end-stage renal disease patient on automated peritoneal dialysis: a case report and literature review

Abstract

Introduction: Peritoneal dialysis (PD) can result in peritonitis, which frequently causes severe and near-fatal clinical implications if left untreated. Usually, gram-positive bacteria are the most common organisms involved. Uncommonly recognized as the cause of peritonitis in PD patients, Neisseria elongata is a gram-negative nasal and oropharyngeal normal flora organism. Case presentation: We report a rare case of a 29-year-old man who had received automated PD for 6 years and had N. elongata peritonitis. Discussion: Several case reports of Neisseria-related peritonitis may point to the potential pathogenicity of such organisms and suggest that many cases of culture-negative peritonitis may have been misdiagnosed. Poor nutrition and chronic kidney disease have been suggested as potential risk factors for N. elongata peritonitis, both of which are present in our patient. With appropriate antibiotic use, most of the cases respond well to empirical treatment. Conclusion: Although rare, N. elongata can lead to PD catheter. peritonitis that, in some cases, require changing to hemodialysis.