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Case Reports
. 2024 Dec 23;16(12):e76280.
doi: 10.7759/cureus.76280. eCollection 2024 Dec.

A Silent Threat Unveiled: Mycobacterium gordonae Catheter-Related Peritonitis in a Patient on Peritoneal Dialysis

Min Aung Hein  1 , Uraiwan Parinyasiri  2 , Dhammika Lehan Wannigama  3   4   5   6   7   8 , Nibondh Udomsantisuk  3 , Talerngsak Kanjanabuch  9   10   11
Affiliations
Case Reports

A Silent Threat Unveiled: Mycobacterium gordonae Catheter-Related Peritonitis in a Patient on Peritoneal Dialysis

Min Aung Hein et al. Cureus. .

Abstract

Infectious complications in peritoneal dialysis (PD) remain a constant challenge, with atypical pathogens posing significant risks. This case from Thailand highlights the rare occurrence of Mycobacterium gordonae, an often-overlooked non-tuberculous mycobacterium (NTM), as the causative agent in a catheter-related exit-site infection that progressed to peritonitis. Initially misattributed to Pseudomonas aeruginosa from preceding exit-site infections, M. gordonae was ultimately identified as the primary pathogen through multiple effluent cultures and advance polymerase chain reaction sequencing. This case underscores the importance of heightened clinical suspicion, early and accurate diagnosis, and timely interventions to prevent severe complications, including hemodialysis transfer.

Keywords: catheter-related infection; exit site infection; mycobacterium gordonae; non-tuberculous mycobacterium; peritoneal dialysis; peritonitis.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. - issued approval -. Chulalongkorn University does not require ethical approval for reporting individual cases or case series. Informed consent, in accordance with the Declaration of Helsinki, was obtained from all participants prior to enrolment. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: Prof. Talerngsak Kanjanabuch Faculty of Medicine, Chulalongkorn University 1873 Rama IV rd., Pathumwan, Bangkok 10130 Tax ID 0994000158041. Financial relationships: Talerngsak Kanjanabuch declare(s) personal fees from VISTERRA. consultancy fees . Talerngsak Kanjanabuch declare(s) a grant from Thailand Science research and Innovation Fund Chulalongkorn University, Royal College of Physicians of Thailand, Ratchadapiseksompotch Fund, Chulalongkorn University, Royal College of Physicians of Thailand, Kidney Foundation of Thailand . Talerngsak Kanjanabuch declare(s) speaking honoraria from AstraZeneca, Baxter Healthcare, Fresenius Medical Care. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Clinical and Microbiological Findings in a Case of Chronic Mycobacterium gordonae Catheter-Related Peritonitis
(A) Chronic exit-site infection with yellowish discharge and moderate crusting surrounding the peritoneal dialysis catheter. (B) M. gordonae colony on Loewenstein-Jensen medium (LJ) (Biomedia, Thailand), showing its distinct yellow-orange pigmentation. (C) Acid-fast bacilli visualized by AFB staining, indicating the presence of mycobacteria.
See this image and copyright information in PMC

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