
Introduction: Peritoneal dialysis (PD) is increasingly used as a replacement method in end-stage chronic renal disease (ESRD), mainly due to its autonomy and quality of life benefits. However, peritonitis in PD, particularly Serratia marcescens peritonitis, can be a serious complication requiring catheter removal. Clinical case: We present the case of a 17-year-old adolescent who presented three episodes of peritonitis in PD characterized by dialysate fluid turbidity, abdominal pain, and vomiting without diarrhea in less than six months. Diagnostic workshop: The peritoneal fluid had a leukocyte count between 4,370 and 16,000 u/ul in each admission. The culture of the peritoneal fluid reported Serratia Marcescens in all three episodes. Treatment: For three weeks, empirical antibiotic treatment was with intraperitoneal ceftazidime (1 g/day, adjusted for antibiogram). After the last episode, the PD catheter was removed, and a second catheter was placed on the contralateral side. Outcome: Four days after catheter insertion, DPA was gradually restarted at low volume. After one year, the patient was free of peritonitis. Conclusions: Serratia marcescens is a gram-negative bacterium primarily responsible for recurrent peritonitis with a poor prognosis. Peritonitis caused by Serratia marcescens, like other Enterobacteriaceae, requires vigilant antibiotic management. Treatment tailored to the recommendations, despite in vitro sensitivity to third-generation cephalosporins, may improve the survival of the technique while preserving the catheter.
Medicine (General), R5-920, Peritoneal dialysis, Catheter removal, Serratia Marcescens, RC870-923, Peritonitis, Internal medicine, RC31-1245, Diseases of the genitourinary system. Urology
Medicine (General), R5-920, Peritoneal dialysis, Catheter removal, Serratia Marcescens, RC870-923, Peritonitis, Internal medicine, RC31-1245, Diseases of the genitourinary system. Urology
| selected citations These citations are derived from selected sources. This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | 0 | |
| popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network. | Average | |
| influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | Average | |
| impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network. | Average |
