Brevundimonas vesicularis Peritonitis in a Chronic Peritoneal Dialysis Patient

Abstract

Gram-negative peritonitis in chronic peritoneal dialysis patients is difficult to treat and may result in catheter loss. <i>Brevundimonas vesicularis</i> is a Gram-negative rod bacterium which rarely causes infections in humans. A 41-year-old male receiving continuous cycling peritoneal dialysis for 5 months developed culture-negative peritonitis. He failed initial empiric treatment with intraperitoneal vancomycin and levofloxacin and thereafter intravenous gentamicin. <i>B. vesicularis</i> resistant to levofloxacin was isolated from the peritoneal fluid 21 days after his initial symptoms. Despite treatment with intravenous ceftriaxone and oral amoxicillin-clavulanate, the infection persisted, which required removal of the peritoneal catheter in order to cure this infection. We describe the features of <i>B. vesicularis</i> infection in our patient and the rarely reported additional cases.