Bacillus subtilis-associated abdominal catastrophe in a Japanese patient with peritoneal dialysis-related peritonitis

Sae Aratani,Yuta Nakagawa,Yukinao Sakai,Yuichiro Sumi,Tsai-Ching Hsu

doi:10.1080/2331205x.2020.1747343

Abstract

Abdominal catastrophe in patients with peritoneal dialysis (PD) is a condition in which visceral injury may cause leakage of enteric microorganisms into the peritoneal cavity, resulting in peritoni...

Highlights

Peritoneal dialysis (PD)-related peritonitis remains the most serious complication in patients undergoing PD and contributes to morbidity, increased risk of hospitalization, and permanent transfer to hemodialysis (Bieber & Mehrotra, 2019)
We report abdominal catastrophe in a patient with PD-related peritonitis, in which B. subtilis was revealed as an etiological agent
Abdominal catastrophe in PD-related peritonitis is a condition in which visceral injury may cause leakage of enteric organisms into the peritoneal cavity, resulting in peritonitis

Summary

Introduction

Peritoneal dialysis (PD)-related peritonitis remains the most serious complication in patients undergoing PD and contributes to morbidity, increased risk of hospitalization, and permanent transfer to hemodialysis (Bieber & Mehrotra, 2019). We report abdominal catastrophe in a patient with PD-related peritonitis, in which B. subtilis was revealed as an etiological agent. The initial abdominal computed tomography (CT) revealed ileus without mechanical obstruction and pelvic abscess (Figure 1). On Day 12 of hospitalization, peritoneal effluent culture further revealed the presence of Candida spp. The patient’s general condition did not allow him to undergo the surgical operation; after discharge from the cardiac care unit, the PD catheter was removed and the patient was switched to maintenance hemodialysis. Abdominal CT was performed for the seventh time, which identified the fistula between the sigmoid colon and pelvic abscess (Figure 2). The arteriovenous fistula was created and the patient was discharged on Day 112 with maintenance hemodialysis and colostomy

Discussion

Findings

Conclusion