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Bacillus licheniformis Peritonitis in a CAPD Patient

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Author(s)
N.H. RyooH.J. ChunD.S. JeonJ.R. KimS.B. Park
Keimyung Author(s)
Ryoo, Nam HeeChun, Hyo JinJeon, Dong SeokKim, Jae RyongPark, Sung Bae
Department
Dept. of Laboratory Medicine (진단검사의학)
Dept. of Internal Medicine (내과학)
Journal Title
Peritoneal Dialysis International
Issued Date
2001
Volume
21
Issue
1
Abstract
A 56-year-old woman was admitted to the hospital with a 2-day history of a sudden onset of persistent
abdominal pain and nausea without vomiting and fever. She had had a 10-year history of hypertension
treated with hypotensive agents, and chronic renal failure for 8 years. She had been treated with hemodialysis
initially then continuous ambulatory peritoneal dialysis (CAPD) due to the occlusion of her arteriovenous
fistula (AVF). This was her third episode of peritonitis, averaging one episode per 16 patient-weeks.
The dialysis effluent showed cloudiness, with a white blood cell (WBC) count of 945 WBC/mm3 with
90% segmented neutrophils. The direct smear of the effluent showed many WBCs and occasional grampositive
bacilli with central or paracentral spores. The effluent culture, on blood agar plate incubated aerobically
at 37°C for 24 hours, revealed typical large blister colonies. These became opaque, wrinkled with
rough surfaces, and b-hemolytic after additional incubation. The isolate was identified as 99% Bacillus
licheniformis using the VITEK automated analyzer (bioMérieux, Hazelwood, MO, U.S.A.) with the ability
to ferment glucose, mannitol, trehalose, maltose, and sucrose, and was positive for esculin and indole. The
patient showed rapid improvement after treatment with netilmycin and cefotiam for 2 days. The dialysis
effluent cell count decreased to 20 WBC/mm3 with diminished turbidity. The follow-up culture of the effluent
had no growth.
Bacillus peritonitis in CAPD is extremely rare; 5 cases have been counted so far in Western literature
(1–4). We report a unique and, as far as we know, the first case of B. licheniformis peritonitis in a CRF
patient being treated with CAPD. On the basis of this case, if the dialysis effluent shows Bacillus species, it
shall not be regarded as a contaminant unless otherwise proven.
Keimyung Author(s)(Kor)
류남희
전효진
전동석
김재룡
박성배
Publisher
School of Medicine
Citation
N.H. Ryoo et al. (2001). Bacillus licheniformis Peritonitis in a CAPD Patient. Peritoneal Dialysis International, 21(1), 97–97.
Type
Article
ISSN
0896-8608
Source
http://www.pdiconnect.com.proxy.dsmc.or.kr/content/21/1/97.long
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33660
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학)
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