Encysted Fluid Collections after Catheter Removal for Peritonitis in Peritoneal Dialysis Patients
Encysted Fluid Collections after Catheter Removal for Peritonitis in Peritoneal Dialysis Patients
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Date
2008
Authors
Hasan Abu-Aisha
Elwaleed A M Elhassan
Maha A Hummeida
Osman-mahir M A Mahir
Hisham M Ali
Aymun I Mobarak
Jamal Abdel-Raheem
Um-Alhasan Mohamed
Hassan A Musa
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Abstract
Introduction: Peritonitis is a frequent complication of
continuous ambulatory peritoneal dialysis (CAPD). This
case series describes episodes of peritoneal dialysis (PD)
related fungal or Pseudomonas peritonitis that were
complicated by the formation of encysted intra abdominal
fluid collections despite prompt catheter removal and
appropriate therapy.
Case series: The first patient presented with fever and
abdominal pain two weeks after removing his PD catheter
because of fungal peritonitis. Examination revealed
fluid collection in the former catheter tunnel. This
turned out to be pus on surgical drainage. Abdominal
computed tomography (CT) scan revealed another
extensive encysted extra-peritoneal fluid collection that
was aspirated and found to be clear transudate fluid.
The second patient presented with abdominal pain and
distention seven weeks after removing her PD catheter
because of fungal peritonitis. She had a large intra
abdominal encysted fluid collection that was drained under
ultra sound guidance. The third patient presented with
painless abdominal distention one month after removing
the PD catheter because of Pseudomonas peritonitis. He
had two encysted extra peritoneal fluid collections that
were aspirated under ultra sound guidance. This occurred
despite three weeks of treatment with oral fluconazole in
the case of the first two patients and appropriate antibiotic
therapy in the case of the third patient.
Conclusion: In fungal and Pseudomonas peritonitis, other
measures besides immediate initiation of appropriate therapy
and prompt removal of the catheter may be necessary to
prevent such late complications. Suggested measures
include continued intraperitoneal antibiotics by a fresh PD
catheter, in addition to systemic antifungal treatment
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Elhassan, E., Hummeida, H., Mahir, O.M., Ali, H., Mobaraka, A., Raheem, J., Mohamed, U., Musa, H. and Abu-Aisha, H., 2008. Encysted fluid collections after catheter removal for peritonitis in peritoneal dialysis patients. Arab Journal of Nephrology and Transplantation, 1(1), pp.25-28.