Peritoneal dialysis-associated peritonitis caused by Brevundimonasaurantiaca.
Wataru Mera, Tomoya Higuchi, Mayuka Higashi et al.
✦ AI-curated · Sources linked
Case in brief
A 55-year-old man with end-stage kidney disease receiving continuous ambulatory peritoneal dialysis developed peritonitis, with Brevundimonas aurantiaca recovered from two consecutive effluent cultures. Routine MALDI-TOF mass spectrometry did not reliably identify the organism; 16S rRNA gene sequencing established the species. Effluent cultures became negative during antimicrobial treatment, but cloudy effluent recurred one week after therapy ended. At recurrence, effluent and catheter cultures were negative, while one of two blood cultures grew Streptococcus agalactiae. The catheter was removed, and the patient improved without further peritonitis episodes.
What made this case unusual
The report describes PD-associated peritonitis due to B. aurantiaca, an organism for which this association had not previously been described. Species-level identification required 16S rRNA sequencing after routine MALDI-TOF mass spectrometry proved unreliable.
Diagnostic / clinical pearl
When routine MALDI-TOF mass spectrometry cannot reliably identify a Brevundimonas isolate from PD effluent, 16S rRNA gene sequencing can provide species-level identification.