MyMedR

Rothia dentocariosa repeat and relapsing peritoneal dialysis-related peritonitis: a case report and literature review

Keng TC, Ng KP, Tan LP, Chong YB, Wong CM, Lim SK

Ren Fail, 2012;34(6):804-6.

PMID: 22506572 DOI: 10.3109/0886022X.2012.678208

Peritonitis is well recognized as the Achilles tendon of peritoneal dialysis (PD). Reoccurrence of peritonitis due to the same organism, defined as either repeat or relapsing peritonitis under the 2005 guidelines by the International Society for Peritoneal Dialysis, often results in PD technique failure. Rothia dentocariosa, a low-virulent human oropharynx commensal, is a rarely reported pathogen in human infection, particularly infective endocarditis. R. dentocariosa PD-related peritonitis is exceedingly uncommon yet potentially results in repeat or relapsing peritonitis which requires catheter removal. We report a case of R. dentocariosa repeat and relapsing peritonitis in a PD patient who was treated successfully with antimicrobial therapy.

Matched MeSH terms: Peritonitis/drug therapy; Peritonitis/microbiology*

Fulltext Bacterial peritonitis in peritoneal dialysis

Cheong IKS, Lim VKE, Ujang K

Med J Malaysia, 1981 Mar;36(1):17-9.

PMID: 7321932

38 episodes of peritonitis in 28 patients were recorded among 97 patients undergoing a total of 159 peritoneal dialysis at the Nephrology Unit, General Hospital, Kuala Lumpur between November 1979 to June 1980. Of these only 14 episodes were associated with a positive bacterial culture. Organism of the Moraxella-Acinetobacter group were responsible in 8 episodes. There were 16 positive cultures in patients who had no clinical evidence of peritonitis. The interpretation of bacterial peritonitis in patients undergoing peritoneal dialysis must be made on the basis of clinical findings and bacteriological reports.

Matched MeSH terms: Peritonitis/etiology*; Peritonitis/microbiology

A rare complication of endoscopic cystgastrostomy

Lee J, Sachithanandan S, Raman K

Gastroenterology, 2011 Nov;141(5):e1-2.

PMID: 21946349 DOI: 10.1053/j.gastro.2010.07.062

Matched MeSH terms: Peritonitis/etiology*; Peritonitis/surgery

Fulltext Edwardsiella tarda septicemia with underlying multiple liver abscesses

Yousuf RM, How SH, Amran M, Hla KT, Shah A, Francis A

Malays J Pathol, 2006 Jun;28(1):49-53.

PMID: 17694959 MyJurnal

Edwardsiella tarda has recently been described as a member of the family Enterobacteriaceae. The genus Edwardsiella contains three species; E. hoshinae, E. ictaluri and E. tarda. Edwardsiella tarda is the only species which has been recognised as pathogenic to humans, especially in those with an underlying disease. The most common presentation is watery diarrhoea. Extra intestinal infections have been reported infrequently. Humans seem to be infected or colonised with Edwardsiella through ingestion or inoculation of a wound. This report is of a patient with multiple liver abscesses due to E. tarda who later developed bacterial peritonitis and septicaemic shock.

Matched MeSH terms: Peritonitis/complications; Peritonitis/microbiology

Fulltext Oral pefloxacin in the treatment of CAPD peritonitis

Tan HW, Kon SP, Chua CT, Ngeow NF

Med J Malaysia, 1992 Jun;47(2):128-33.

PMID: 1494333

Continuous ambulatory peritoneal dialysis (CAPD), a widely used replacement therapy for end stage renal failure, is frequently complicated by bacterial peritonitis. The infecting organisms are mainly staphylococci and gram negative aerobes. Pefloxacin is a fluorinated quinolone with good in-vitro activity against these pathogens. The objective of this open non comparative study is to determine the effectiveness and safety of oral pefloxacin mesylate as a single first line antimicrobial treatment of CAPD peritonitis. 28 episodes of CAPD peritonitis were treated with a stat dose of pefloxacin 800 mg. followed by 400 mg. 12 hourly for about 15-18 days. A pefloxacin sensitive organism was isolated in 17 episodes. 11 episodes were culture negative. Treatment results showed a cure in seventeen (60.7%), no treatment response in seven (25%), and relapses in four (14.2%). Side effects encountered were not serious except for one incident of a generalized seizure. We conclude that oral pefloxacin is convenient, safe and effective enough as a single first line antimicrobial treatment for CAPD peritonitis.

Matched MeSH terms: Peritonitis/drug therapy*; Peritonitis/etiology

Fulltext Protocol for a randomised, open-label, parallel group, multicentre controlled study to evaluate the clinical performance and safety of Stay Safe Link compared with Stay Safe in patients with end-stage kidney disease on continuous ambulatory peritoneal dialysis

Mak WY, Ong LM, Goh BL, Bavanandan S, Mushahar L, Leong CT, et al.

BMJ Open, 2019 03 08;9(3):e024589.

PMID: 30852538 DOI: 10.1136/bmjopen-2018-024589

INTRODUCTION: Peritonitis is a major complication of continuous ambulatory peritoneal dialysis (CAPD), the risk of which is significantly influenced by the type of PD transfer system. Although the Y-disconnect and double-bag system is more efficient in preventing peritonitis compared with the spike system, little information is available to differentiate risks between different brands of the Y-disconnect double-bag system. A randomised controlled trial to evaluate the safety and efficacy of a newly introduced system is needed to provide the necessary clinical evidence to guide policy decision-making.

METHODS AND ANALYSIS: The study is an open-label randomised controlled trial. A total of 434 patients with end-stage renal disease undergoing CAPD will be enrolled and randomised to either the intervention group, Stay Safe Link, or the control group, Stay Safe. All study subjects will be followed up and monitored for 1 year. The primary safety outcome is the rate of peritonitis while the primary efficacy outcomes are the delivered dialysis dose and ultrafiltration volume.

ETHICS AND DISSEMINATION: The study was approved by the Medical Research Ethics Committee, National Institute of Health Malaysia. A written informed consent will be obtained from all participating subjects prior to any trial-related procedure and the study conduct will adhere strictly to Good Clinical Practice. The findings will be disseminated in a peer-reviewed journal.

TRIAL REGISTRATION NUMBER: NCT03177031; Pre-results.

Matched MeSH terms: Peritonitis/etiology; Peritonitis/prevention & control*

Fulltext Descriptive distribution and phylogenetic analysis of feline infectious peritonitis virus isolates of Malaysia

Sharif S, Arshad SS, Hair-Bejo M, Omar AR, Zeenathul NA, Fong LS, et al.

Acta Vet Scand, 2010 Jan 06;52(1):1.

PMID: 20053278 DOI: 10.1186/1751-0147-52-1

The descriptive distribution and phylogeny of feline coronaviruses (FCoVs) were studied in cats suspected of having feline infectious peritonitis (FIP) in Malaysia. Ascitic fluids and/or biopsy samples were subjected to a reverse transcription polymerase chain reaction (RT-PCR) targeted for a conserved region of 3'untranslated region (3'UTR) of the FCoV genome. Eighty nine percent of the sampled animals were positive for the presence of FCoV. Among the FCoV positive cats, 80% of cats were males and 64% were below 2 years of age. The FCoV positive cases included 56% domestic short hair (DSH), 40% Persian, and 4% Siamese cats. The nucleotide sequences of 10 selected amplified products from FIP cases were determined. The sequence comparison revealed that the field isolates had 96% homology with a few point mutations. The extent of homology decreased to 93% when compared with reference strains. The overall branching pattern of phylogenetic tree showed two distinct clusters, where all Malaysian isolates fall into one main genetic cluster. These findings provided the first genetic information of FCoV in Malaysia.

Matched MeSH terms: Feline Infectious Peritonitis/epidemiology*; Feline Infectious Peritonitis/virology*

β Mangostin suppress LPS-induced inflammatory response in RAW 264.7 macrophages in vitro and carrageenan-induced peritonitis in vivo

Syam S, Bustamam A, Abdullah R, Sukari MA, Hashim NM, Mohan S, et al.

J Ethnopharmacol, 2014 Apr 28;153(2):435-45.

PMID: 24607509 DOI: 10.1016/j.jep.2014.02.051

The fruit hull of Garcinia mangostana Linn. has been used in traditional medicine for treatment of various inflammatory diseases. Hence, this study aims to investigate the in vitro and in vivo anti-inflammatory effect of β mangostin (βM), a major compound present in Garcinia mangostana.

Matched MeSH terms: Peritonitis/chemically induced; Peritonitis/drug therapy*; Peritonitis/metabolism*

Fulltext Congenital trans-mesenteric herniation: a rare cause of small intestine strangulation in adults

Umaparan G, Nallusamy K, Abdul Wahab MH, Mohammad Nor AM, Mat Arif NA

J Surg Case Rep, 2012 Dec 04;2012(11).

PMID: 24968390 DOI: 10.1093/jscr/rjs003

Trans-mesenteric hernia is a form of internal hernia which is an extremely rare cause of intestinal obstruction in adults compared with the pediatric population. It often presents with complications such as acute intestinal obstruction and peritonitis requiring immediate surgical intervention. We report a case of a 21-year-old woman who presented to us with an acute abdomen and peritonitis that required an immediate exploratory laparotomy. She was found to have a small congenital mesenteric defect with strangulated segment of ileum. Gangrenous portion of the ileum was resected and the congenital defect was closed. The patient made an uneventful recovery. The occurrence of trans-mesenteric hernia in adults is rare and difficult to be diagnosed clinically; thus, the patient's clinical features may lead to early surgical intervention in order to reduce morbidity and mortality.

Matched MeSH terms: Peritonitis

Fulltext Exit-Site Dressing and Infection in Peritoneal Dialysis: A Randomized Controlled Pilot Trial

Mushahar L, Mei LW, Yusuf WS, Sivathasan S, Kamaruddin N, Idzham NJ

Perit Dial Int, 2015 09 15;36(2):135-9.

PMID: 26374836 DOI: 10.3747/pdi.2014.00195

♦

OBJECTIVE: Peritoneal dialysis (PD)-related infection is a common cause of catheter loss and the main reason for PD drop-out. Exit-site infection (ESI) is a pathway to developing tunnel infection and peritonitis, hence rigorous exit-site care has always been emphasized in PD therapy. The aim of this study was to evaluate the effect of exit-site dressing vs non-dressing on the rate of PD-related infection. ♦

METHODS: A prospective randomized controlled study was conducted in prevalent PD patients at the Hospital Tuanku Jaafar Seremban, Negeri Sembilan, Malaysia, from April 2011 until April 2013. All patients were required to perform daily washing of the exit site with antibacterial soap during a shower. In the dressing group (n = 54), patients were required to clean their exit site using povidone-iodine after drying, followed by topical mupirocin antibiotic application to the exit site. The exit site was then covered with a sterile gauze dressing and the catheter immobilized with tape. In the non-dressing group (n = 54), patients were not required to do any further dressing after drying. They were only required to apply mupirocin cream to the exit site and then left the exit site uncovered. The catheter was immobilized with tape. The primary outcome was ESI. The secondary outcomes were evidence of tunnel infection or peritonitis. ♦

RESULTS: A total of 97 patients completed the study. There were a total of 12 ESI episodes: 4 episodes in 4 patients in the dressing group vs 8 episodes in 4 patients in the non-dressing group. This corresponds to 1 episode per 241.3 patient-months vs 1 episode per 111.1 patient-months in the dressing and non-dressing groups respectively. Median time to first ESI episode was shorter in the non-dressing than in the dressing group, but not significant (p = 0.25). The incidence of gram-positive ESI in both groups was similar. There were no gram-negative ESI in the non-dressing group compared with 2 in the dressing group. The peritonitis rate was 1 per 37.1 patient-month in the dressing group and 1 per 44.4 patient-months in the non-dressing group. Median time to first peritonitis episode was significantly shorter in the dressing group compared to non-dressing (p = 0.03). There was no impact of dressing disruptions in the occurrence of major PD catheter-related infection. ♦

CONCLUSION: Use of a non-dressing technique with only prophylactic topical mupirocin cream application is effective in preventing PD-related infection. The non-dressing technique is more cost-effective and convenient for PD patients, with fewer disposables.

Matched MeSH terms: Peritonitis/epidemiology*; Peritonitis/prevention & control; Peritonitis/therapy

Fulltext Two cases of spontaneous pneumoperitoneum without peritonitis

Shahrudin MD

Med J Malaysia, 1993 Dec;48(4):449-52.

PMID: 8183172

Spontaneous pneumoperitoneum without peritonitis is a rare phenomenon which poses a dilemma to the surgeons faced with this problem. Two such cases and their outcome are presented. The first case was caused by tracheal rupture during emergency intubation and was treated by observation until complete resolution. The second case was caused by barotrauma during positive pressure ventilation and was treated by laparotomy. Both patients died for reasons unrelated to the pneumoperitoneum. The passage of air from the chest cavity into the abdominal cavity was along the great vessels in the first case and through the diaphragm in the second. A compilation of other aetiologies of pneumoperitoneum without peritonitis as extracted from the literature is presented. In the presence of pneumoperitoneum without peritonitis and when the clinical history does not suggest visceral perforation, an abdominal tap or lavage should be attempted. If negative, continued observation is advised.

Matched MeSH terms: Peritonitis

Fulltext An Aubergine in My … Case of Rectal Foreign Body

Mohamad IS, Yaacob H

Malays Fam Physician, 2018;13(3):47-48.

PMID: 30800236 MyJurnal

A 24-year-old man presented to the casualty department with a history of left-sided, colicky abdominal pain for one day. It was associated with an inability to pass flatus or motion within the same duration. There was no history of vomiting. On examination, the vital signs were within normal limits, and he was afebrile. His abdomen was soft, but a hard mass was palpable on the left side of his abdomen. There was no peritonitis. The bowel sounds were sluggish.

Matched MeSH terms: Peritonitis

Surgical ascites

Nadarajah C

Journal of the Malaya Branch of the British Medical Association, 1940;3:423-4.

Matched MeSH terms: Peritonitis, Tuberculous

Fulltext Delayed Bowel Perforation after Routine Distal Loopogram Prior to Ileostomy Closure

Poh KS, Hoh SY, Aziz R, Chong SS, Roslani AC

Open Med (Wars), 2020;15:261-265.

PMID: 32292822 DOI: 10.1515/med-2020-0037

Ultra-low anterior resection for low rectal cancer is usually done with a covering ileostomy as a safety measure to reduce the consequences of distal anastomotic failure. In many centres, distal loopogram is performed routinely, prior to the closure of the loop ileostomy, to assess the integrity of anastomosis. Distal loopogram is generally considered a safe procedure with very low complication rates, especially when water-soluble contrast is used. We report two cases of delayed bowel perforation which led to severe sepsis and generalized peritonitis after distal loopogram prior to ileostomy closure. Our cases highlight the potential dangers of distal loopogram. Therefore, the routine usage of this procedure should be scrutinized and the patient needs to be properly counselled prior to the procedure.

Matched MeSH terms: Peritonitis

Fulltext Evaluation of Modified Laboratory Processes for Isolation of Bacteria and Fungi in Continuous Ambulatory Peritoneal Dialysis Patients with Peritonitis

Ahmadi S, Amin-Nordin S, Neela VK, Hamat RA, Goh BL, Nor LA, et al.

Perit Dial Int, 2015 Dec;35(7):767-9.

PMID: 26703853 DOI: 10.3747/pdi.2013.00154

Matched MeSH terms: Peritonitis/microbiology*

A randomized, multicenter, open-label trial to establish therapeutic equivalence between the Carex and ultra disconnect systems in patients on continuous ambulatory peritoneal dialysis

Ong LM, Lim TO, Hooi LS, Morad Z, Tan PC, Wong HS, et al.

Perit Dial Int, 2003 Dec;23 Suppl 2:S139-43.

PMID: 17986534

OBJECTIVE: In the present study, we undertook to establish therapeutic equivalence with respect to peritonitis and technique failure between the Carex disconnect system (B. Braun Carex, Mirandola, Italy) and the standard Ultra system (Baxter Healthcare, Tokyo, Japan) in patients on continuous ambulatory peritoneal dialysis (CAPD).

DESIGN: This multicenter, parallel group, randomized controlled trial involved 363 prevalent CAPD patients from 8 centers. The primary endpoint was peritonitis rate; secondary endpoints were technique failure and technical problems encountered. The duration of the evaluation was 1 year.

RESULTS: The risk of peritonitis on Carex varied between the centers. We found a significant treatment-center interaction effect (likelihood ratio test: p = 0.03). The incidence rate ratio (IRR) of peritonitis on Carex as compared with Ultra ranged from 0.4 to 7.2. In two centers, Carex was inferior to Ultra with regard to peritonitis; but, in five centers, the results were inconclusive. Equivalence was not demonstrated in any center. The overall rate of peritonitis in the Carex group was twice that in the Ultra group [IRR: 2.18; 95% confidence interval (CI): 1.51 to 3.14]. Technique failure and technical problems were more common with the Carex system. Technique failure rate at 1 year was 44% in the Carex group and 22% in the Ultra group.

CONCLUSIONS: Equivalence between the Carex disconnect system and the Ultra disconnect system could not be demonstrated. The risk of peritonitis on Carex varied significantly between centers.

Matched MeSH terms: Peritonitis/epidemiology*

Common bile duct perforation due to tuberculosis: a case report

Jarmin R, Alwi RI, Shaharuddin S, Salleh KM, Gunn A

Asian J Surg, 2004 Oct;27(4):342-4.

PMID: 15564193

A young man with HIV presented with biliary peritonitis secondary to spontaneous common bile duct perforation. Investigation revealed that the perforation was due to Mycobacterium tuberculosis. Tuberculosis of the bile duct is uncommon and usually presents with obstructive jaundice due to stricture. Bile duct perforation due to tuberculosis is extremely rare. Its management is discussed.

Matched MeSH terms: Peritonitis/etiology

Infections in patient with decompensated cirrhosis

Suresh RL

Med J Malaysia, 2005 Jul;60 Suppl B:16.

PMID: 16108167

Matched MeSH terms: Peritonitis/microbiology*

Fulltext Barium peritonitis--following barium enema of the proximal colon through a colostomy

Liew NC, Gee T, Sandra K, Gul YA

Med J Malaysia, 2003 Dec;58(5):766-8.

PMID: 15190666

Perforation with extravasation of barium is a rare complication of contrast enema examination of the large bowel with a high associated mortality rate. The experience of performing a re-laparotomy in a patient previously exposed to barium peritonitis is even less common. We describe an elderly male patient with a Hartmann's procedure performed a year previously, presenting with peritonitis following barium enema evaluation of the proximal colon via an end descending colon stoma. Emergency laparotomy, segmental bowel resection and liberal peritoneal toilet resulted in a satisfactory outcome. The patient had a subsequent successful reversal of his Hartmann's procedure nine months later despite the presence of dense barium induced adhesions. This potentially preventable iatrogenic complication is discussed in this report, which is supplemented by a brief review of the English literature.

Matched MeSH terms: Peritonitis/chemically induced*

Fulltext Ultrastructure of Felis catus whole fetus (Fcwf-4) cell culture following infection with feline coronavirus

Alazawy A, Arshad SS, Bejo MH, Omar AR, Tengku Ibrahim TA, Sharif S, et al.

J Electron Microsc (Tokyo), 2011;60(4):275-82.

PMID: 21593079 DOI: 10.1093/jmicro/dfr031

Feline coronavirus (FCoV) consists of two biotypes based on their growth in cell culture and their antigenicity. Infections with FCoV are highly prevalent in the cat population worldwide. In this study, Felis catus whole fetus (Fcwf-4)cell culture was infected with FCoV UPM11C/08. Virus multiplication in cell culture was monitored and examined under the transmission electron microscope. The virus particles revealed the characteristic morphology of feline FCoV represented by envelope viruses surrounded by peplomers. Virus attachment and entry into the cell occurred 15 h post-infection (pi), and the myriad of virus particles were observed both extracellularly and intracellularly after 48 h pi. Thereafter, intracellular virus particles were observed to be present in vacuoles or present freely in the cytoplasm.

Matched MeSH terms: Feline Infectious Peritonitis/virology

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