Pediatric Nephrology

, Volume 19, Issue 1, pp 114–117

Mycobacterial peritonitis in pediatric peritoneal dialysis patients

  • Elizabeth Ferrara
  • Jacques Lemire
  • Paul C. Grimm
  • Vivian M. Reznik
  • Stanley A. Mendoza
  • John A. Leake
  • Nadine M. Benador
Brief Report

DOI: 10.1007/s00467-003-1348-1

Cite this article as:
Ferrara, E., Lemire, J., Grimm, P.C. et al. Pediatr Nephrol (2004) 19: 114. doi:10.1007/s00467-003-1348-1

Abstract

Peritonitis is the most common complication and the leading cause of death in pediatric peritoneal dialysis (PD) patients. According to the most recent data available from the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS), approximately 25% of pediatric PD patients who die succumb to infection. There are no reported cases of Mycobacterium tuberculosis (MTB) or Mycobacterium avium-intracellulare peritonitis in the NAPRTCS registry. With an increasing incidence of MTB worldwide and the impairment of cellular immunity in chronic renal failure patients, it is not surprising that mycobacterium peritonitis can occur in PD patients. We report two pediatric PD patients with mycobacterial peritoneal infection diagnosed over an 11-year period at our institution. One patient presented with a malfunctioning Tenckhoff catheter and again 3 years later with hyponatremia and ascites. The other presented with recurrent culture-negative peritonitis. These cases illustrate the importance of more extensive evaluation of PD complications, to include evaluation for mycobacterium with special media or peritoneal biopsy, in the above clinical settings if the routine work-up is unrevealing.

Keywords

Peritoneal dialysisPeritonitisMycobacterium tuberculosisMycobacterium avium-intracellulareDifferential cell count

Copyright information

© IPNA 2003

Authors and Affiliations

  • Elizabeth Ferrara
    • 1
  • Jacques Lemire
    • 1
  • Paul C. Grimm
    • 1
  • Vivian M. Reznik
    • 1
  • Stanley A. Mendoza
    • 1
  • John A. Leake
    • 2
  • Nadine M. Benador
    • 1
  1. 1.Department of Pediatrics, Division of Pediatric NephrologyUniversity of California San DiegoSan DiegoUSA
  2. 2.Division of Pediatric Infectious DiseasesChildren’s Hospital and Health CenterSan DiegoUSA