Persistent exit-site infection in peritoneal dialysis - An unrecognized window to abdominal viscera.

Persistent exit-site infection in peritoneal dialysis - An unrecognized window to abdominal viscera. Perit Dial Int. 2020 Apr 23;:896860820920134 Authors: Domingos AT, Malho Guedes A, Mendes FB, Vidinha J, Bernardo I, Neves PL Abstract Exit-site (ES) infection is a common complication in peritoneal dialysis (PD). Pseudomonas spp. is particularly difficult to treat, and catheter removal should be considered in persistent infections. The authors present a chronic ES infection resistant to directed antibiotic therapy in which catheter salvage was not possible. Removal was very difficult due to the presence of white sponge-like tissue with petrous consistency surrounding the catheter, all the way into the peritoneum. Histology revealed well-differentiated adenocarcinoma infiltrates. Abdominal computed tomography scan revealed a solid pancreatic (tail) lesion, nodular images on the greater epiploon, an adnexal lesion and a hepatic solid lesion, consistent with metastasis. The patient was referred for palliative care but maintained PD until untreatable pain and deterioration of general status aroused. Somewhere along the course of a chronic ES infection, the peritoneal catheter (and inflammation) was the metastatic path of an unknown pancreatic cancer, with neoplastic tissue reaching the skin. Catheter removal was crucial for diagnosis. PMID: 32323638 [PubMed - as supplied by publisher]
Source: Peritoneal Dialysis International - Category: Urology & Nephrology Tags: Perit Dial Int Source Type: research