Peritonitis from Anaerobic Gram-positive Cocci Likely Due to Translocation of Bacteria from Gut in a Patient Undergoing Peritoneal Dialysis

Peritonitis is a severe complication encountered in patients undergoing peritoneal dialysis, often causing high morbidity and mortality. High vigilance is required from healthcare providers involved in the management of these patients to prevent this complication. There has been recognition of peritonitis caused by unusual organisms because of improved microbiological detection techniques. Gram-positive organisms are the frequent cause of peritonitis compared to Gram-negative organisms. We report a rare case of peritonitis caused by Enterococcus avium. A 60-year-old male on peritoneal dialysis presented with palpitations, abdominal pain, diarrhea, and cloudy effluent. The peritoneal fluid analysis was consistent with peritonitis, and peritoneal fluid culture grew E. avium. The patient was treated with linezolid after failing to respond to vancomycin. The peritoneal dialysis catheter was removed, and the dialysis modality has been switched to hemodialysis because of refractory peritonitis.