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Normal Peritoneum After Nine Years of Peritoneal Dialysis with Biocompatible Dialysate: A Case Report

and vancomycin was administered intravenously after specimens of blood and peritoneal effluent had been collected for culture. Six days later, bacterial culture of the peritoneal effluent yielded gram-negative bacteria, which were further confirmed as b. thetaiotaomicron. Antibiotic susceptibility tests revealed that the organism was sensitive to chloramphenicol and metronidazole, but resistant to clindamycin and penicillin. The antibiotics were therefore changed to metronidazole for 10 days, and the patient recovered completely without complications. To our knowledge, human infection caused by b. thetaiotaomicron is extremely rare. Based on limited case reports, this unusual pathogen had been found to be associated with meningitis, bacteremia, and wound infection (1–5). Here, we document the first case of PD peritonitis caused by b. thetaiotaomicron, which was confirmed by compatible symptoms and signs, and positive bacterial culture from peritoneal effluent. The portal of entry for this infection with b. thetaiotaomicron remains unclear. However, given that the organism resides in and dominates the human intestinal tract, the most probable mechanism is bacterial translocation from the gastrointestinal tract to the peritoneum. To summarize, we report a case of PD peritonitis caused by b. thetaiotaomicron. This case expands the spectrum of infection caused by b. thetaiotaomicron and raises the possibility of b. thetaiotaomicron as a potential cause of PD peritonitis.