Pasteurella multocida peritonitis associated with a cat in a peritoneal dialysis patient using an automated cycler device

Abstract

Pasteurella multocida (P. multocida) is an aerobic Gram-negative coccobacillus, which is found as part of the natural oral flora of many animals, including most healthy cats and dogs. However, it can cause a variety of infections in humans, usually as a result of the patient being bitten or scratched by a cat or dog. There have been 22 reported cases of P. multocida peritonitis in patients undergoing peritoneal dialysis (PD). Of these, 66.7 % occurred within 12 months of the initiation of PD. Only two cases (11.1 %) developed more than 60 months after the commencement of PD. We report a case of P. multocida peritonitis involving a 45-year-old patient who had been undergoing continuous ambulatory peritoneal dialysis (CAPD) for 84 months without a previous history of peritonitis, who developed P. multocida peritonitis associated with a domestic cat on the very night on which he began using an automated cycler device to switch from CAPD to continuous cyclic peritoneal dialysis (CCPD). Patients maintained on PD who keep pets such as cats or dogs at home should be educated about the risk of developing peritonitis related to their domestic pets, and this warning should be repeated when such patients switch from CAPD to CCPD. Physicians should consider using empiric therapy to prevent P. multocida in pet-owning PD patients who present with a history of PD fluid leakage and peritonitis, especially in patients who use cycler devices.

Keywords: Cycler device; Pasteurella multocida; Peritoneal dialysis; Peritonitis.