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Renal medicine
Peritoneal dialysis-related Listeria monocytogenes peritonitis treated with both intravenous and intraperitoneal ampicillin
  1. Scott MacKay1,
  2. Benjamin W Ewanchuk1 and
  3. Mark McIsaac2
  1. 1University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  2. 2Nephrology, University of Alberta, Edmonton, Alberta, Canada
  1. Correspondence to Dr Mark McIsaac; mmcisaac{at}ualberta.ca

Abstract

Listeria monocytogenes is a ubiquitous bacterium and opportunistic pathogen for immunocompromised patients. Peritoneal dialysis-related L. monocytogenes peritonitis is a rare clinical presentation, with a total of 23 cases reported to date and an overall mortality rate of 17.3%. The current report describes a case of peritoneal dialysis-related L. monocytogenes peritonitis in a woman in her 60s on long-term immunosuppressive therapies for a prior renal transplant. We treated this patient successfully with intraperitoneal ampicillin (125 mg/L in dialysate), in addition to intravenous ampicillin (1 g every 12 hours) for 10 days and subsequent oral amoxicillin 500 mg every 12 hours to complete a total 21-day course of therapy. This treatment regimen was informed by a literature review of pre-existing case studies, which demonstrated considerable variability in recommended antimicrobial dosing and frequency. A summary of this literature review is included in the current case report.

  • Renal medicine
  • Dialysis

https://doi.org/10.1136/bcr-2024-260033

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    Footnotes

    • Contributors SMK, BWE and MM were responsible for drafting the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content and gave final approval of the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.