Roseomonas mucosa-Induced Peritonitis in a Patient Undergoing Continuous Cycler Peritoneal Dialysis: Case Report and Literature Analysis

Abstract

Roseomonas species, a rare Gram-negative microorganism, has seldom been reported to cause peritonitis in end-stage renal disease patients on peritoneal dialysis. Only seven cases of peritonitis by this rare microorganism have been reported worldwide. Treatment options can be challenging if not detected early and can lead to significant morbidity and mortality along with the switching of the dialysis modality to hemodialysis which is highly undesirable. Our patient is a 65-year-old Caucasian female who needed to be changed to emergency hemodialysis due to inability to perform peritoneal dialysis from suspected peritonitis and was subsequently discovered to have peritonitis from Roseomonas mucosa. She recovered with a prolonged antibiotics course and returned to peritoneal dialysis in 3 months following her treatment completion. Prompt diagnosis and prolonged antibiotics are a cornerstone in the management of this rare microorganism to prevent mortality and morbidity from peritonitis.

Infective Spondylitis with Epidural Abscess Formation Caused by Roseomonas mucosa: A Case Report and Literature Review

“…In the past, it was generally believed that R. mucosa is not highly pathogenic to immunocompetent populations. A systematic review [ 9 ] suggests that R. mucosa infections occur more frequently in immunocompromised patients or patients with severe comorbidities, including dialysis [ 14 , 15 ], cancer [ 16 , 17 ], HIV [ 18 ], and autoimmune disease [ 10 ]. In addition, the placement of catheter should be considered a risk factor [ 19 , 20 ], and the assessment of whether to remove the relevant catheter after infection is considered an essential part of the treatment [ 21 ].…”

Cellulitis caused by Roseomonas mucosa in a child: a case report

“…R. mucosa has been frequently reported as an opportunistic infection in immunocompromised patients [ 5 – 15 , 17 – 21 , 24 ] and those with catheter-related bloodstream [ 5 – 14 ] or postoperative [ 16 , 22 , 23 ] infections. In the present case, the skin barrier function was originally impaired due to sebum-deficient eczema, and the local immunosuppressive effects caused by topical steroids were assumed to have contributed to an increased susceptibility to infection.…”

“…Reports of R. mucosa infection in humans are limited; however, there have been reports of catheter-related bloodstream infections [ 5 – 14 ] and infections in immunocompromised patients. Cases of bacteremia [ 4 – 18 ], peritonitis [ 18 – 21 ], meningitis [ 22 ], infection of soft tissues [ 4 ], spinal epidural abscess [ 23 ], pyogenic spondylitis [ 16 ], cholangitis [ 11 ], subretinal abscess [ 24 ], infection of the root canal [ 25 ], and liver abscess [ 26 ] have also been reported. R. mucosa is resistant to broad-spectrum cephalosporins [ 2 , 3 ].…”

“…Many patients in these reports were immunocompromised [ 5 – 15 , 17 – 21 , 24 ] or had catheter-related [ 5 – 14 ] or postoperative infections [ 16 , 22 , 23 ], with few reports of infection in patients without these characteristics [ 26 ]. Reports of skin and soft tissue infections are also rare.…”

Roseomonas Species Bacteremia With Associated Endocarditis and Possible CNS Septic Embolic Phenomenon

“…Rosemonas mucosa has been associated with infection in different hosts immunocompetent and immunocompromised manifesting as peritonitis, bacteremia, catheter-related bacteremia, endophthalmitis, spondylitis [1][2][3][4][5][6], one case by Shao et al reported a case of infective endocarditis in a patient with lupus [7]. Its resistance to cephalosporins including cefepime makes it a health problem that needs to be identified promptly to prevent the development of complications related to infection.…”