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March 1984

Campylobacter Septicemia After Peritonitis Complicating Peritoneal Dialysis

Arch Intern Med. 1984;144(3):653. doi:10.1001/archinte.1984.00350150267058

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

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