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Abstract: FR-PO478

Home Pets and Peritonitis: Friend or Foe?

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis


  • Shaikh, Zahir Ali, Albert Einstein Medical Center, Philadelphia, Pennsylvania, United States
  • Dissanayake, Imara, Albert Einstein Medical Center, Philadelphia, Pennsylvania, United States
  • Angamuthu, Akilandanayaki, Albert Einstein Medical Center, Philadelphia, Pennsylvania, United States
  • Gupta, Astha, Albert Einstein Medical Center, Philadelphia, Pennsylvania, United States

Peritonitis is a major complication in peritoneal dialysis and remains the main cause of patients switching to hemodialysis. The usual organisms in peritonitis are pathogenic skin bacteria including staphylococcus epidermidis and staphylococcus aureus. There are rare causes which include gram negative and fungal peritonitis.
Here we are presenting a case of pasturela multocida which is transferred by pets, especially cats.

Case Description

A 41 year old male with medical history of type 1 diabetes mellitus, hypertension, hyperlipidemia, coronary artery disease status post coronary artery bypass graft, end stage renal disease on continuous cycler peritoneal dialysis came with nausea, vomiting and watery diarrhea of one week.
On admission, the exit site was clean with some redness at the peritoneal dialysis catheter insertion site. The initial PD cell count was 8 with 36% neutrophils, however, the PD fluid culture was reported as gram negative rods the following day.
The repeat cell count was 2287 with 69% polymorphs. The patient was started on intraperitoneal Cefepime for gram negative peritonitis while awaiting culture and sensitivity. Subsequently the PD fluid culture was positive for pasturella multocida and patient was switched to intraperitoneal ceftriaxone.
On further questioning regarding pets at home, the patient attested that his cat plays around the machine tubings while he connects himself for peritoneal dialysis.
The patient recovered, however he developed relapsing peritonitis, which was treated successfully, and patient remains on peritoneal dialysis with no complications eight months later.


Pasturela multocida is an aerobic, small gram negative coccobacillus found in pets (cats & dogs) as part of their normal oral flora. it can cause a variety of infections in humans through scratching, licking or biting, leading to infections ranging from mild cellulitis to severe pneumonia, sepsis or meningitis. Treatment includes penicillin, third generation cephalosporins and carbapenems.
The pasturela multocida peritonitis in a peritoneal dialysis is rare, however needs to be considered in patients having pets.
The patient's home environment & understanding of sanitization measures should be discussed in detail with patients before starting on peritoneal dialysis and nurse should visit patient's home to ensure the safety and sanitization measures.