Improvement of multiple intraperitoneal nodules resembling peritoneal cancer that developed after peritoneal dialysis-related peritonitis caused by Mycobacterium abscessus with literature review: granuloma or carcinoma

Abstract

Abstract Introduction Peritonitis is a crucial complication that leads to hospitalization or even death in patients who are undergoing peritoneal dialysis (PD). The incidence of PD-related peritonitis associated with nontuberculous mycobacteria has increased in recent years. However, a well-established treatment for peritonitis is lacking, particularly in peritonitis caused by Mycobacterium abscessus which is a difficult to treat disease due to its inherent resistance to majority of available antibiotics. To the best of our knowledge, this case is the first to report on intraperitoneal multiple nodules that developed due to PD-related peritonitis caused by M. abscessus. Case presentation This case reported a case of a 40-year-old female patient who was undergoing PD and who showed multiple intraperitoneal nodules that resembled peritoneal cancer on computed tomography (CT) and that developed after PD-related peritonitis and catheter removal. After multiantibiotic therapy, multiple nodules were found to have disappeared on CT. The nodules continued to disappear and the patient did not show signs of recurrent peritonitis, although there was a possibility of recurrence. Conclusion To the best of our knowledge, this case is the first to report on nodules that resembled peritoneal cancer and that developed in the abdominal cavity due to PD-related peritonitis caused by M. abscessus. Positron emission tomography–CT was not useful in distinguishing peritoneal cancer from nodules caused by M. abscessus.