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Case Report: Recurring Peritonitis and Dialysis Failure in a Toddler on Peritoneal Dialysis

We report a case of a 2-year-old-boy with end stage renal disease (ESRD) secondary to posterior urethral valves (PUV) on peritoneal dialysis (PD). Our patient developed multiple episodes of peritonitis, refractory anemia and feeding intolerance over a 12-month-period. He was treated with multiple co...

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Autores principales: Mohammed, Enas H., Chandy, Sajimol, Kadhi, Abderrahman E., Shatat, Ibrahim F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969517/
https://www.ncbi.nlm.nih.gov/pubmed/33748045
http://dx.doi.org/10.3389/fped.2021.632915
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author Mohammed, Enas H.
Chandy, Sajimol
Kadhi, Abderrahman E.
Shatat, Ibrahim F.
author_facet Mohammed, Enas H.
Chandy, Sajimol
Kadhi, Abderrahman E.
Shatat, Ibrahim F.
author_sort Mohammed, Enas H.
collection PubMed
description We report a case of a 2-year-old-boy with end stage renal disease (ESRD) secondary to posterior urethral valves (PUV) on peritoneal dialysis (PD). Our patient developed multiple episodes of peritonitis, refractory anemia and feeding intolerance over a 12-month-period. He was treated with multiple courses of intraperitoneal antibiotics. Despite being on high-calorie formula, he was slowly thriving. The feeding intolerance was attributed to past history of prematurity, gastro-esophageal reflux disease and ESRD co-morbidities. He had anemia resistant to erythrocyte stimulating agents and iron supplementation. His family received re-training and mastered the PD techniques. They reported no breach of the aseptic techniques. His workup which included multiple AP abdominal XR-plain films were read as unremarkable and showed the gastrostomy tube (GT) and the PD catheter in good position. He completed his antibiotic courses as prescribed after each peritonitis episode, peritoneal fluid cultures repeated after each treatment completion showed no growth. During the last peritonitis episode, our patient developed ultrafiltration failure. A cross-table abdominal XR was obtained to evaluate the peritoneal catheter position and showed an intra-abdominal foreign body. During surgery, a needle was laparoscopically removed from the ileum and the PD catheter was replaced. Subsequently, our patient's feeding intolerance and resistant anemia resolved. Finally PD was successfully resumed.
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spelling pubmed-79695172021-03-19 Case Report: Recurring Peritonitis and Dialysis Failure in a Toddler on Peritoneal Dialysis Mohammed, Enas H. Chandy, Sajimol Kadhi, Abderrahman E. Shatat, Ibrahim F. Front Pediatr Pediatrics We report a case of a 2-year-old-boy with end stage renal disease (ESRD) secondary to posterior urethral valves (PUV) on peritoneal dialysis (PD). Our patient developed multiple episodes of peritonitis, refractory anemia and feeding intolerance over a 12-month-period. He was treated with multiple courses of intraperitoneal antibiotics. Despite being on high-calorie formula, he was slowly thriving. The feeding intolerance was attributed to past history of prematurity, gastro-esophageal reflux disease and ESRD co-morbidities. He had anemia resistant to erythrocyte stimulating agents and iron supplementation. His family received re-training and mastered the PD techniques. They reported no breach of the aseptic techniques. His workup which included multiple AP abdominal XR-plain films were read as unremarkable and showed the gastrostomy tube (GT) and the PD catheter in good position. He completed his antibiotic courses as prescribed after each peritonitis episode, peritoneal fluid cultures repeated after each treatment completion showed no growth. During the last peritonitis episode, our patient developed ultrafiltration failure. A cross-table abdominal XR was obtained to evaluate the peritoneal catheter position and showed an intra-abdominal foreign body. During surgery, a needle was laparoscopically removed from the ileum and the PD catheter was replaced. Subsequently, our patient's feeding intolerance and resistant anemia resolved. Finally PD was successfully resumed. Frontiers Media S.A. 2021-03-04 /pmc/articles/PMC7969517/ /pubmed/33748045 http://dx.doi.org/10.3389/fped.2021.632915 Text en Copyright © 2021 Mohammed, Chandy, Kadhi and Shatat. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Mohammed, Enas H.
Chandy, Sajimol
Kadhi, Abderrahman E.
Shatat, Ibrahim F.
Case Report: Recurring Peritonitis and Dialysis Failure in a Toddler on Peritoneal Dialysis
title Case Report: Recurring Peritonitis and Dialysis Failure in a Toddler on Peritoneal Dialysis
title_full Case Report: Recurring Peritonitis and Dialysis Failure in a Toddler on Peritoneal Dialysis
title_fullStr Case Report: Recurring Peritonitis and Dialysis Failure in a Toddler on Peritoneal Dialysis
title_full_unstemmed Case Report: Recurring Peritonitis and Dialysis Failure in a Toddler on Peritoneal Dialysis
title_short Case Report: Recurring Peritonitis and Dialysis Failure in a Toddler on Peritoneal Dialysis
title_sort case report: recurring peritonitis and dialysis failure in a toddler on peritoneal dialysis
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969517/
https://www.ncbi.nlm.nih.gov/pubmed/33748045
http://dx.doi.org/10.3389/fped.2021.632915
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