To the Editor.
—A 62-year-old patient treated by continuous ambulatory peritoneal dialysis (CAPD) had peritonitis caused by Campylobacter fetus subspecies intestinalis, a bacterium seldom isolated in this setting. Tobramycin sulfate and cefazolin sodium were added to the dialysate for three weeks, with rapid resolution.Twenty-five days later, our patient had a clinical picture of septicemia and local inflammation at a still-functioning arteriovenous fistula. Two blood cultures drawn a week apart yielded the same Campylobacter subspecies as previously isolated. Parenteral tobramycin administration followed by a course of oral erythromycin ethylsuccinate effected a cure.Continuous ambulatory peritoneal dialysis is still often complicated by peritonitis, which is sometimes caused by unusual organisms.1 In contrast to C jejuni, which usually causes acute gastroenteritis in children, C fetus intestinalis is an opportunistic organism that infects adults, often elderly, debilitated persons, with symptoms of systemic illness, including bacteremia.2The two previously described patients with
Wens RE, Dratwa M, Potvliege C, Hansen WM, Tielemans CL, Collart FE. Campylobacter Septicemia After Peritonitis Complicating Peritoneal Dialysis. Arch Intern Med. 1984;144(3):653. doi:10.1001/archinte.1984.00350150267058