Vancomycin
- PDF / 141,904 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 0 Downloads / 148 Views
1
S
Chemical peritonitis following intraperitoneal administration: case report A 34-year-old man on peritoneal dialysis (PD) developed chemical peritonitis during treatment with intraperitoneal vancomycin. The man had renal failure secondary to diabetic nephropathy and was on PD since 2006. Icodextrin was initiated 1 year later. In 2009, he came to a hospital with a 4-hour history of mild abdominal pain. Effluent was clear. He was started to receive intraperitoneal vancomycin 2g every 5 days and ceftazidime. Icodextrin was continued. The next day following the first dose of vancomycin, he returned with cloudy effluent. Effluent analysis revealed a WBC count of 340 /µL, a neutrophil count of 238 /µL and a monocyte count of 102 /µL. The same treatment was maintained, and the effluent became clear in the following 2 days. On day 5, he was asymptomatic and returned for the second dose of intraperitoneal vancomycin. Later that day, he reported abdominal pain, and the effluent was cloudy again. Analysis revealed a WBC count of 3000 /µL, a neutrophil count of 2250 /µL and a monocyte count of 450 /µL. Vancomycin and ceftazidime were switched to the IV route, and he received an additional dose of intraperitoneal ceftazidime. PD was stopped and haemodialysis started. The man became asymptomatic again and the effluent clear. All effluent cultures were sterile. On day 9, the man restarted PD with icodextrin. After receiving another dose of intraperitoneal vancomycin on day 10, the effluent was cloudy again. Analysis revealed a WBC count of 7162 /µL, a neutrophil count of 5819 /µL and a monocyte count of 1044 /µL. He was asymptomatic on day 12 and was discharged. Three months later, he was asymptomatic and the effluent remained clear. Author comment: "In our patient, neither temporal relation with icodextrin administration was detected nor was relapse noted after rechallenge. A temporal relation with the vancomycin administration supported the diagnosis of vancomycin-induced chemical peritonitis." Freitas C, et al. Chemical peritonitis in a patient treated with icodextrin and intraperitoneal vancomycin. Nefrologia 31: 625-6, No. 5, 2011. Available from: URL: http://dx.doi.org/10.3265/nefrologia.pre2011.jun.10989 803068831 Portugal
0114-9954/10/1396-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 7 Apr 2012 No. 1396
Data Loading...
