Peritonitis due to Neisseria mucosa in an adolescent receiving peritoneal dialysis

• Published in: Infection Vol. 33; no. 5-6; pp. 390 - 392
• Main Authors: Shetty, A K, Nagaraj, S K, Lorentz, W B, Bitzan, M
• Format: Journal Article
• Language: English
• Published: Germany Springer Nature B.V 01.10.2005
• Subjects: Adolescent; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - pharmacology; Ceftriaxone - administration & dosage; Ceftriaxone - pharmacology; Cephalothin - administration & dosage; Cephalothin - pharmacology; Gentamicins - administration & dosage; Gentamicins - pharmacology; Glomerulonephritis, IGA - complications; Humans; Injections, Intraperitoneal; Male; Neisseria mucosa; Neisseria mucosa - isolation & purification; Neisseriaceae Infections - microbiology; Peritoneal Dialysis - adverse effects; Peritonitis - drug therapy; Peritonitis - microbiology
• ISSN: 0300-8126; 1439-0973
• DOI: 10.1007/s15010-005-5074-4

Neisseria mucosa is part of the normal nasopharyngeal flora and rarely pathogenic in humans. Reports of serious infections associated with this pathogen are very unusual. A 17-year-old boy with end-stage renal disease due to IgA nephropathy presented with acute, spontaneous, symptomatic peritoneal dialysis-associated peritonitis without reported break in sterility or PD catheter exit site infection. beta-lactamase-negative N. mucosa was isolated from the dialysate effluent. Intraperitoneal antibiotic treatment with cephalothin/gentamicin for 5 days and subsequent ceftriaxone led to complete resolution of the infection. This case demonstrates that "non-pathogenic" Neisseria species can cause clinically severe peritonitis with high intraperitoneal neutrophil counts, elevated C-reactive protein levels in the peritoneal effluent (in the presented case, 27,600/mul and 3.6 mg/l, respectively) and impaired peritoneal membrane transport function. To our knowledge, this is the first case of N. mucosa peritonitis complicating chronic peritoneal dialysis in an adolescent patient.