tailieunhanh - báo cáo khoa học: "Unusual presentation of peritonitis with persistent clear aspirate: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Unusual presentation of peritonitis with persistent clear aspirate: a case report | Asicioglu et al. Journal of Medical Case Reports 2010 4 383 http content 4 1 383 jAl JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Unusual presentation of peritonitis with persistent clear aspirate a case report 1 1 12 1 1 1 Ebru Asicioglu Arzu Kahveci Elif Ari Bakir Atilla Bulur Hakki Arikan Mehmet Koc Serhan Tuglular Cetin Ozener1 Abstract Introduction Peritonitis is the most frequent complication of peritoneal dialysis. Diagnosis of peritonitis includes symptoms and signs of peritonitis with a cloudy aspirate of more than 100 WBC ml as well as positive cultures. Although sterile peritonitis has been reported in the literature to the best of our knowledge this is the first report of an unusual presentation of peritonitis without any white blood cells in the peritoneal aspirate despite multiple positive peritoneal cultures. Case presentation An 82-year-old Caucasian man who had been on continuous cycling peritoneal dialysis for 12 years was admitted to our hospital with general malaise loss of appetite weight loss and somnolence. He did not describe abdominal pain or fever. Even though his peritoneal fluid was consistently negative for leukocytes and clear he had peritonitis with different organisms consecutively. Conclusions Our case report shows that any patient on peritoneal dialysis presenting with evidence of infection fever peripheral leukocytosis without an obvious cause should have aspirate cultures done even if the aspirate is clear and abdominal pain is absent. Our case report may change the initial work-up and management of these patients. We believe this report is of interest to general medicine and emergency room physicians as well as nephrologists. Introduction Peritonitis is the most frequent complication of peritoneal dialysis PD . Diagnosis of peritonitis includes symptoms and signs of peritonitis with a cloudy aspirate of more than 100 WBC ml as well as positive cultures. Although sterile peritonitis has .

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