2018, Cilt 27, Sayı 2, Sayfa(lar) 211-213
A Rare Cause of Peritonitis in Children on Automated Peritoneal Dialysis: Pseudomonas Putida
DOI 10.5262/tndt.2017.1003.21
Belde KASAP DEMIR1,2 Caner ALPARSLAN2, Fatma MUTLUBAŞ2, Önder YAVAŞCAN2, Duygu ERTAN3, Demet ALAYGUT2, Serdar SARITAŞ3, Nejat AKSU2
1İzmir Katip Çelebi Üniversitesi, Çocuk Nefroloji Bilim Dalı, İzmir, Türkiye
2SBÜ Tepecik Eğitim ve Araştırma Hastanesi, Çocuk Nefrolojisi Yandal Eğitim Kliniği, İzmir, Türkiye
3SBÜ Tepecik Eğitim ve Araştırma Hastanesi, Çocuk Sağlığı ve Hastalıkları Klinikleri, İzmir, Türkiye
Keywords: Children, Peritonitis, Peritoneal dialysis, Pseudomonas putida

Peritonitis associated with gram-negative bacteria presents difficulties in the follow-up of patients with chronic peritoneal dialysis. Especially in perionitis related to Pseudomonas spp., treatment becomes difficult and may lead to catheter removal. However, some strains may differ. Here, we present a 14-year-old girl with P. putida peritonitis while on automated peritoneal dialysis due to familial Mediterranean fever (FMF)-related amyloidosis and end-stage renal failure. The patient was admitted with abdominal pain, fever, vomiting and cloudy peritoneal fluid starting one day before the admission. She was diagnosed with peritonitis when additional large amounts of leukocytes with 100% polymorphic nucleated cells were found in the peritoneal fluid. Intraperitoneal cefepime treatment was instituted empirically and systemic cefepime was added for up to three days when catheter dysfunction developed. The peritoneal fluid culture yielded cefepime sensitive P. putida and the treatment was stopped at the end of two weeks. No peritonitis recurrence or technical survival problem was found in the follow-up period. It was thought that infection with P. putida, which is thought to be an opportunistic pathogen with low virulence and high response to antibiotic therapy seen in immunosuppressive patients, may be related to canakinumab, which was being used by our case. The case was presented with the aim of drawing attention to the fact that although a pseudomonal peritonitis, two weeks of cefepime monotherapy may be sufficient for P. putida peritonitis.

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