A peritoneal dialysis patient with fatal culture-negative peritonitis

Nephrology (Carlton). 2003 Feb;8(1):49-55. doi: 10.1046/j.1440-1797.2003.00119.x.


Culture-negative peritoneal inflammation accounts for between 5 and 20% of cases of peritonitis in peritoneal dialysis patients. Diagnostic yields may be enhanced considerably by reculturing dialysate effluents using appropriate collection methods and optimal laboratory techniques (including prolonged low-temperature and anaerobic incubations). In patients with persistent culture-negative peritonitis, consideration should be given to the possibilities of unusual or fastidious microorganisms (especially fungi and mycobacteria) and non-infective causes (especially drug reactions, malignancy, visceral inflammation and retroperitoneal inflammation). In this paper, an illustrative case of persistent culture-negative peritonitis is presented followed by a discussion of the investigative approach to such patients, with particular emphasis on differential diagnosis and the limitations of currently available tests.

Publication types

  • Case Reports

MeSH terms

  • Diagnosis, Differential
  • Fatal Outcome
  • Female
  • Humans
  • Middle Aged
  • Peritoneal Dialysis*
  • Peritonitis / diagnosis*
  • Peritonitis / etiology