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NDT Plus Advance Access originally published online on September 18, 2008
NDT Plus 2009 2(1):59-62; doi:10.1093/ndtplus/sfn150
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

White tide

Dipa Chatterjee1, Laurie R. Solomon1, Uwe Roesler2, Amanda Barnes3 and Alexander Woywodt1

1 Renal Unit, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK
2 Institute of Animal and Environmental Hygiene, Free University Berlin, Berlin, Germany
3 Consultant Microbiologist, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK

Correspondence: Correspondence and offprint requests to: Alexander Woywodt, Renal Unit, Lancashire Teaching Hospitals NHS Trust, Royal Preston Hospital, Sharoe Green Lane, Preston, PR2 9HT, UK. Tel: +44-1772-524629; Fax: +44-1772-522162; E-mail: Alex.Woywodt@lthtr.nhs.uk

Key Words: differential diagnosis • peritoneal dialysis • peritonitis • prototheca • rare organisms

Received for publication August 19, 2008. Accepted for publication August 21, 2008.

The first 150 words of the full text of this article appear below.


   Introduction
 
Infectious problems, such as exit-site infection and peritonitis, are common complications of peritoneal dialysis (PD). Peritonitis is usually bacterial and either caused by gram-positive organisms as a sequel to handling errors or by gram-negative bacteria as a result of underlying gastrointestinal pathology. Several antibiotic guidelines have been formulated. We present a case of PD peritonitis that provided an interesting challenge after cultures grew a rare organism. We discuss the case with an emphasis on rare organisms and the factors associated with these infections.


   Case
 
A 35-year-old female patient on peritoneal dialysis (PD) presented with abdominal pain and turbid dialysis fluid in August 2004 after several previous episodes of PD peritonitis.

She had been diagnosed with medullary cystic disease on the basis of a renal biopsy and reached end-stage renal disease in February 1998 when CAPD was initiated. An inguinal hernia was repaired in September 2000, and an umbilical hernia was repaired . . . [Full Text of this Article]


   Discussion
 

   Teaching points
 

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