Nocardia asteroides peritonitis in peritoneal dialysis patients: Case report and review of the literature.

Nocardia is a rare pathogen of peritoneal dialysis-related peritonitis despite its universal presence in soil, organic matter, and water. Human infections are seen mostly in immunocompromized hosts. The usual primary site of lesions is lung. Nocardia can enter the peritoneal cavity through the Tenckhoff catheter. We describe the first case of nocardia peritonitis that had associated nocardia pneumonia. The Tenckhoff catheter was removed due to nonresolution of peritonitis. The organism was resistant to sulfamethoxazole-trimethoprim. The patient developed hypotension, disseminated intravascular coagulation, and respiratory failure and died.