Encapsulating peritoneal sclerosis in a peritoneal dialysis patient presenting with complicated mycobacterium fortuitum peritonitis

• Published in: Saudi journal of kidney diseases and transplantation Vol. 23; no. 3; pp. 635 - 641
• Main Authors: Simbli, Muhammad Amin, Niaz, Faraz Azim, al-Wakil, Jamal S.
• Format: Journal Article
• Language: English
• Published: Riyadh, Saudi Arabia Saudi Center for Organ Transplantation 01-05-2012; Medknow Publications and Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Subjects: Aged; Anti-Bacterial Agents - therapeutic use; Care and treatment; Diabetic Nephropathies - etiology; Diabetic Nephropathies - therapy; Diagnosis; Fatal Outcome; Female; Humans; Kidney Failure, Chronic - etiology; Kidney Failure, Chronic - therapy; Liver Diseases - etiology; Multiple Organ Failure - etiology; Mycobacterial diseases; Mycobacterial infections; Mycobacterium fortuitum - isolation & purification; Mycobacterium Infections, Nontuberculous - diagnosis; Mycobacterium Infections, Nontuberculous - etiology; Mycobacterium Infections, Nontuberculous - microbiology; Mycobacterium Infections, Nontuberculous - therapy; Parenteral Nutrition, Total; Peritoneal dialysis; Peritoneal Dialysis, Continuous Ambulatory - adverse effects; Peritoneal Fibrosis - diagnosis; Peritoneal Fibrosis - etiology; Peritoneal Fibrosis - therapy; Peritonitis - diagnosis; Peritonitis - etiology; Peritonitis - microbiology; Peritonitis - therapy; Renal Dialysis; Sclerosis; Tomography, X-Ray Computed; Treatment Outcome; Saudi Arabia
• ISSN: 1319-2442; 2320-3838
• DOI: 10.4103/1319-2442.95861

Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication seen in
patients undergoing continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis APD after prolonged duration on dialysis. Patients usally present with vague complaints of abdominal pain, vomitting, diarrhea, weight loss and change in peritoneal transport characteristics. High degree of suspicion is needed in PD patients who have been on dialysis for prolonged duration and have been using high-concentrated dialysis fluid. Mycobacterium fortuitum (MF) is a rapidly growing, non-tuberculous mycobacterium that has rarely been reported as a pathogen causing peritonits in patients on PD. We report a case of CAPD presenting with culture-negative peritonits, which, on specific culture, grew MF and, on radiological evaluation, showed diagnostic features of EPS.