Relapsing peritonitis caused by Bordetella bronchiseptica in continuous ambulatory peritoneal dialysis patient: a case report

Abstract

Bordetella (B) bronchiseptica is a common veterinary pathogen, but has rarely been implicated in human infections. Most patients with B. bronchiseptica infections are compromised clinically such as in patients with a malignancy, AIDS, malnutrition, or chronic renal failure. We experienced a case of relapsing peritonitis caused by B. bronchiseptica associated with continuous ambulatory peritoneal dialysis (CAPD). A 56-yr-old male, treated with CAPD due to end stage renal disease (ESRD), was admitted with complaints of abdominal pain and a turbid peritoneal dialysate. The culture of peritoneal dialysate identified B. bronchiseptica. The patient was treated with a combination of intraperitoneal antibiotics. There were two further episodes of relapsing peritonitis, although the organism was sensitive to the used antibiotics. Finally, the indwelling CAPD catheter was removed and the patient was started on hemodialysis. This is the first report of a B. bronchiseptica human infection in the Korean literature.

Keywords: Bordetella Bronchiseptica; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis.

Fig. 1

Gram-stained smear of peritoneal dialysate showing scattered gram-negative coccobacilli (arrows) among neutrophils.

Fig. 2

Sheep blood agar plate showing 1-2 mm sized, raised, grayish-white colonies after 48 hr incubation at 37℃C, 5%-CO₂.

Fig. 3

Gram-stained smear of colony on BAP after 48 hr incubation at 37℃C showing gram negative coccobacili.