Abstract
Peritonitis is a major cause of morbidity in peritoneal dialysis patients; however, Aeromonas caviae rarely causes peritonitis in these patients. We report peritonitis due to A. caviae in a 72-year-old male with end-stage renal failure who had been undergoing automated peritoneal dialysis for 1 year. The white blood cell (WBC) count in the peritoneal fluid was $2,722/mm^3$ with 85% neutrophils. Gram staining of the peritoneal fluid yielded Gram-negative rods. Empirical antibiotic therapy with ceftriaxone was initiated intraperitoneally. However, drug sensitivity testing revealed that the organism was resistant. On the third hospital day, A. caviae was cultured from the peritoneal effluent, and the antibiotic regimen was switched to ciprofloxacin. The patient recovered rapidly and the WBC count of the peritoneal effluent decreased. He was discharged and the intraperitoneal ciprofloxacin therapy was continued for 14 days. The peritoneal catheter was not removed.
저자들은 국내에는 보고된 적이 없으며 복막투석 환자에서 복막염의 매우 드문 원인 균주인 Aeromonas caviae에 의한 복막염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 복막투석 관련 복막염 치료에 있어 드문 균주에 대해서도 충분히 고려해야 할 것이며, 투석방법 및 복막투석 도관이나 연결관 등의 기술적인 발전에도 불구하고 개인 위생 교육과 같은 주기적인 환자 교육이 복막염의 예방에 가장 근본적인 측면이라고 할 수 있겠다.