Peritoneal dialysis-associated peritonitis caused by Eikenella corrodens combined with Enterococcus avium: A case report and literature review.

RATIONALE: Peritoneal dialysis-associated peritonitis (PDAP), caused by co-infection with Eikenella corrodens and Enterococcus avium is extremely rare. To the best of our knowledge, this is the first reported case of successful management without catheter removal.

PATIENT CONCERNS: A 75-year-old male on continuous ambulatory peritoneal dialysis presented with persistent abdominal pain, abdominal distension, and cloudy peritoneal dialysate.

DIAGNOSES: Microbiological cultures of the peritoneal dialysate identified Eikenella corrodens and Enterococcus avium as causative pathogens.

INTERVENTIONS: The initial empirical treatment with intraperitoneal cefoperazone-sulbactam and cefazolin was ineffective. Based on the antimicrobial susceptibility results, the regimen was switched to levofloxacin, which targets both organisms.

OUTCOMES: After a 3-week course of levofloxacin, the patient's symptoms resolved completely, the peritoneal dialysate indices normalized, and the peritoneal catheter was successfully retained.

LESSONS: This case highlights that the early identification of atypical pathogens and targeted antibiotic therapy can lead to favorable outcomes in rare co-infections causing PDAP, potentially avoiding catheter removal.