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MYCOBACTERIUM CHELONEI PERITONITIS IN A PATIENT UNDERGOING CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD)

Dept. of Medical Microbiology^* and Nephrology, University of Montreal and Hôtel-Dieu Hospital, Montreal, P. Quebec, Canada

This paper describes a case of Mycobacterium chelonei peritonitis associated with continuous ambulatory peritoneal dialysis (CAPD). The patient probably acquired the infection from tap water. He presented with cloudy effluent, abdominal pain and systemic toxicity. Originally, gram stain, Ziehl-Neelsen stain, aerobic and anaerobic cultures were negative. One week later, culture grew an aerobic, fast growing, acidfast bacterium, which later was identified as Mycobacterium chelonei. The peritonitis was treated successfully with erythromycin and catheter removal. The diagnosis of tuberculous and non-tuberculous mycobacterial peritonitis during CAPD can be difficult. Compared to usual bacterial peritonitis associated with CAPD, everything in these cases proves to be nonspecific. Mycobacterial infection should be suspected in all episodes of culture-negative peritonitis especially those which do not respond to usual antimicrobial therapy.

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