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A case of peritoneal dialysis-associated peritonitis by Rothia mucilaginosa.

Kim BG, Cho AY, Kim SS, Lee SH, Shin HS, Yoon HJ, Kim JG, Sun IO, Lee KY - Kidney Res Clin Pract (2015)

Bottom Line: Rothia muciliaginosa (R. mucilaginosa) is a facultative, Gram-positive coccus that is considered to be part of the normal flora of the mouth and respiratory tract.There are sporadic reports of the organism causing endocarditis in patients with heart valve abnormalities, as well as meningitis, septicemia, and pneumonia associated with intravenous drug abuse.Although R. mucilaginosa is generally susceptible to penicillin, ampicillin, cefotaxime, imipenem, rifampicin, and glycopeptides, there are no guidelines for the treatment of PD-associated peritonitis.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea.

ABSTRACT
Rothia muciliaginosa (R. mucilaginosa) is a facultative, Gram-positive coccus that is considered to be part of the normal flora of the mouth and respiratory tract. There are sporadic reports of the organism causing endocarditis in patients with heart valve abnormalities, as well as meningitis, septicemia, and pneumonia associated with intravenous drug abuse. However, it is an unusual pathogen in cases of peritoneal dialysis (PD)-associated peritonitis. Although R. mucilaginosa is generally susceptible to penicillin, ampicillin, cefotaxime, imipenem, rifampicin, and glycopeptides, there are no guidelines for the treatment of PD-associated peritonitis. Herein, we report a case of PD-associated peritonitis due to R. mucilaginosa that was resolved with intraperitoneal antibiotic treatment.

No MeSH data available.


Related in: MedlinePlus

Serial changes of white blood cell count in peritoneal effluents during hospitalization. Peritoneal white blood cell count increased up to 3,680/mm3 and recovered to normal levels in a short time span. R. mucilaginosa, Rothia mucilaginosa; S. mitis, Streptococcus mitis; WBC, white blood cell.
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f0005: Serial changes of white blood cell count in peritoneal effluents during hospitalization. Peritoneal white blood cell count increased up to 3,680/mm3 and recovered to normal levels in a short time span. R. mucilaginosa, Rothia mucilaginosa; S. mitis, Streptococcus mitis; WBC, white blood cell.

Mentions: The peritoneal WBC count decreased to 30/mm3, and the patient׳s clinical condition improved on the 5th day after starting intraperitoneal cefazolin and ceftazidime. The patient recovered after a 2-week course of intraperitoneal antibiotics. However, he complained of abdominal pain and turbid peritoneal effluent 3 days after termination of intraperitoneal antibiotics. The WBC count of the peritoneal effluents was 2,140/mm3 with a neutrophil predominance (80%). We restarted intraperitoneal cefazolin and ceftazidime, and repeated culture of the peritoneal dialysate revealed S. mitis. According to the International Society for Peritoneal Dialysis guidelines, we recommended removal of the PD catheter, but he refused our recommendation. Therefore, we maintained intraperitoneal antibiotics, and the patient improved after intraperitoneal antibiotics for 2 weeks; however, the patient experienced turbid peritoneal effluent 10 days after cessation of the second round of intraperitoneal antibiotics. The WBC count of the peritoneal effluents was 2,080/mm3 with a neutrophil predominance (85%), and repeated culture of the peritoneal dialysate revealed R. mucilaginosa. The peritoneal WBC count decreased to 8/mm3, and abdominal pain disappeared on the 3rd day after starting intraperitoneal cefazolin and ceftazidime. The patient׳s condition improved, and he was discharged after a 2-week course of intraperitoneal antibiotics (Fig. 1).


A case of peritoneal dialysis-associated peritonitis by Rothia mucilaginosa.

Kim BG, Cho AY, Kim SS, Lee SH, Shin HS, Yoon HJ, Kim JG, Sun IO, Lee KY - Kidney Res Clin Pract (2015)

Serial changes of white blood cell count in peritoneal effluents during hospitalization. Peritoneal white blood cell count increased up to 3,680/mm3 and recovered to normal levels in a short time span. R. mucilaginosa, Rothia mucilaginosa; S. mitis, Streptococcus mitis; WBC, white blood cell.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608873&req=5

f0005: Serial changes of white blood cell count in peritoneal effluents during hospitalization. Peritoneal white blood cell count increased up to 3,680/mm3 and recovered to normal levels in a short time span. R. mucilaginosa, Rothia mucilaginosa; S. mitis, Streptococcus mitis; WBC, white blood cell.
Mentions: The peritoneal WBC count decreased to 30/mm3, and the patient׳s clinical condition improved on the 5th day after starting intraperitoneal cefazolin and ceftazidime. The patient recovered after a 2-week course of intraperitoneal antibiotics. However, he complained of abdominal pain and turbid peritoneal effluent 3 days after termination of intraperitoneal antibiotics. The WBC count of the peritoneal effluents was 2,140/mm3 with a neutrophil predominance (80%). We restarted intraperitoneal cefazolin and ceftazidime, and repeated culture of the peritoneal dialysate revealed S. mitis. According to the International Society for Peritoneal Dialysis guidelines, we recommended removal of the PD catheter, but he refused our recommendation. Therefore, we maintained intraperitoneal antibiotics, and the patient improved after intraperitoneal antibiotics for 2 weeks; however, the patient experienced turbid peritoneal effluent 10 days after cessation of the second round of intraperitoneal antibiotics. The WBC count of the peritoneal effluents was 2,080/mm3 with a neutrophil predominance (85%), and repeated culture of the peritoneal dialysate revealed R. mucilaginosa. The peritoneal WBC count decreased to 8/mm3, and abdominal pain disappeared on the 3rd day after starting intraperitoneal cefazolin and ceftazidime. The patient׳s condition improved, and he was discharged after a 2-week course of intraperitoneal antibiotics (Fig. 1).

Bottom Line: Rothia muciliaginosa (R. mucilaginosa) is a facultative, Gram-positive coccus that is considered to be part of the normal flora of the mouth and respiratory tract.There are sporadic reports of the organism causing endocarditis in patients with heart valve abnormalities, as well as meningitis, septicemia, and pneumonia associated with intravenous drug abuse.Although R. mucilaginosa is generally susceptible to penicillin, ampicillin, cefotaxime, imipenem, rifampicin, and glycopeptides, there are no guidelines for the treatment of PD-associated peritonitis.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea.

ABSTRACT
Rothia muciliaginosa (R. mucilaginosa) is a facultative, Gram-positive coccus that is considered to be part of the normal flora of the mouth and respiratory tract. There are sporadic reports of the organism causing endocarditis in patients with heart valve abnormalities, as well as meningitis, septicemia, and pneumonia associated with intravenous drug abuse. However, it is an unusual pathogen in cases of peritoneal dialysis (PD)-associated peritonitis. Although R. mucilaginosa is generally susceptible to penicillin, ampicillin, cefotaxime, imipenem, rifampicin, and glycopeptides, there are no guidelines for the treatment of PD-associated peritonitis. Herein, we report a case of PD-associated peritonitis due to R. mucilaginosa that was resolved with intraperitoneal antibiotic treatment.

No MeSH data available.


Related in: MedlinePlus