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Continuous Ambulatory Peritoneal Dialysis-Related Peritonitis in an Uremic Outpatient: Achromobacter xylosoxidans

signs of infection were observed at the CAPD catheter exit site or tunnel. His physical examination was normal except for abdominal tenderness. The peritoneal effluent cell count of 1,220 cells/mm 3 with 95% polymorphonuclear leukocytes revealed no bacilli and standard culture technique was performed. Urine analysis revealed leukocyturia (394 leukocytes/ml) without hematuria . The results of initial laboratory tests are summarized in table 1 . Despite the improvements in disconnecting systems, peritonitis is highly associated with significant morbidity. Achromobacter xylosoxidans (AX; formerly Alcaligenes xylosoxidans ) is an aerobic, motile, oxidase and catalase-positive, nonlactose fermenting Gram-negative bacillus [1] . AX-related peritonitis is rare in endstage renal disease patients under con tinuous ambulatory peritoneal dialysis (CAPD) therapy. The majority of published clinical reports of AX peritonitis are due to nosocomial infections in immunocompromised patients. Herein, we present the first CAPD-related peritonitis episode in an outpatient caused by AX and discuss treatment options for this peritonitis. A 31-year-old male patient was admitted to the hospital complaining of diffuse abdominal pain and cloudy dialysate for 2 days. He had obstructive uropathy due to kidney stones for 5 years, which was complicated by end-stage renal failure. The patient had been receiving CAPD therapy for 11 months and had not had a CAPD-related peritonitis episode since the initiation. The prior medical history of the patient was remarkable for recurring urinary tract infection (UTI) due to Pseudomonas aeruginosa . A double-J catheter that had been placed because of renal stones was removed 2 months before admission. No Published online: July 17, 2012