Abstract: SA-PO0401
Paws for Concern: A Case of Pasteurella Peritonitis and Exit Site Infection in a Patient on Automated Peritoneal Dialysis
Session Information
- Home Dialysis: Science and Cases, from Lab to Living Room
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Gutierrez, Jorge, Weill Cornell Medicine, New York, New York, United States
- Mohapatra, Shrusty, Jawaharlal Nehru Medical College, Belagavi, KA, India
- Shimonov, Daniil, Weill Cornell Medicine, New York, New York, United States
Introduction
Pasteurella multocida is a gram-negative coccobacillus known to colonize the upper respiratory tract of domestic animals causing skin and soft tissue infections following bites in humans. Pasteurella species can cause peritonitis in patients on peritoneal dialysis (PD). We report a case of a 19-year-old female on automated PD (APD) with peritonitis and exit site infection secondary to Pasteurella that was successfully treated without removing the PD catheter.
Case Description
A 19-year-old female with end-stage kidney disease (ESKD) due to bilateral renal hypoplasia on APD for the past year presented with hypertension, fever, abdominal pain, and cloudy effluent for two days. On physical exam, she had bilateral lower extremity edema, abdominal distention and tenderness. The PD catheter exit site was without tenderness or erythema but brown malodorous discharge was noted with granulation tissue suspicious for exit site infection. Laboratory tests were significant for leukocytosis. The peritoneal fluid had a total white blood cell count of 5850/uL with 4738/uL (81%) neutrophils. Patient was admitted and started on IV vancomycin and piperacillin/tazobactam. Her symptoms and laboratory tests improved within 48 hours. Peritoneal fluid culture was positive for Pasteurella multocida. Upon re-evaluation the patient mentioned that she had moved into a new apartment with her friend who had a cat that bit through the uncovered APD tubing. Antibiotics were narrowed to IV ampicillin/sulbactam and she was discharged on a course of intraperitoneal Ceftazidime to complete a 2-week course. Given rapid recovery she did not need removal of the PD catheter and continue with PD after re-education.
Discussion
This patient developed PD peritonitis and an exit site infection due to Pasteurella as a result of her friend’s cat biting on the exposed APD tubing. She was able to start antibiotics promptly and salvage her PD catheter. Recently, the ISPD guidelines outlined management of PD peritonitis and catheter related infections, noting that infections are more likely to occur in APD as opposed to manual PD probably due to longer tubing. Although having pets is not an absolute contraindication to doing PD, educating patients to maintain a clean home environment and keeping pets away from the PD tubing are keys to preventing infection.