J Med Cases

Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc

Journal website http://www.journalmc.org

Case Report

Volume 9, Number 9, September 2018, pages 289-292

Secondary Peritonitis in Peritoneal Dialysis: A Case Report and Review of Literature

**Table 1.** Patient’s Vitals and Laboratory Values
Vitals
Temperature	102.5
Blood Pressure	143/90
Pulse	93
Respiration	20
Laboratory values
White blood cell count	11,300 cells/mm³
Hemoglobin	8.6 g/dL
PD fluid white count	9,420 cells/mm³
Cytology	Mixed inflammation, predominantly neutrophilic; proteinaceous material and negative for malignancy

Table 1. Patient’s Vitals and Laboratory Values

Vitals

Temperature

102.5

Blood Pressure

143/90

Pulse

Respiration

Laboratory values

White blood cell count

11,300 cells/mm³

Hemoglobin

8.6 g/dL

PD fluid white count

9,420 cells/mm³

Cytology

Mixed inflammation, predominantly neutrophilic; proteinaceous material and negative for malignancy

**Table 2.** Characteristics of Patients on PD With Peritonitis From Perforation
No.	Sex	Age (years)	Delay in diagnosis	Culture	CT scan results	Findings at surgery	Outcome
1 [14]	M	63	2	Multiple enteric organisms		Perforated diverticulitis	Survived
2 [14]	M	83	5	Multiple enteric organisms		Perforated diverticulitis	Survived
3 [14]	M	69	3	E. coli		Infarction right colon	Died (MI)
4 [14]	M	57	27	Multiple enteric organisms		Perforated diverticulitis	Died (sepsis)
5 [14]	F	66	5	Multiple enteric organisms		Ischemic colitis	Died (sepsis)
6 [14]	M	77	UD	Multiple enteric organisms		Perforated diverticulitis (autopsy)	Died (MI)
7 [14]	F	69	6	Multiple enteric organisms		Perforated diverticulitis	Survived
8 [15]	F	75	3	E. coli, Pseudomonas aeruginosa		Appendicitis	Survived, on HD
9 [15]	F	44	2	E. coli		Tubo-ovarian abscess	Survived, on PD
10 [15]	M	50	1	E. coli		Perforated sigmoid diverticulitis	Survived, on HD
11 [15]	M	80	2.5	E. coli		Perforated gastric cancer	Survived on HD
12 [15]	F	61	3	E. coli		Perforated Sigmoid diverticulitis	Survived on HD
13 [15]	F	66	3	E. coli		Mesenteric Infarct	Died
14 [15]	F	57	1	E. coli, anaerobes		Cecal perforation and colonic infarct	Died
15 [15]	M	78	12	E. coli, Clostridium, Anaerobes		Perforated sigmoid diverticulitis	Survived on HD
16 [15]	M	44	1	E. coli, Anaerobes		Small bowel infarction	Died (on table)
17 [15]	M	51	3	Pseudomonas, Candida albicans, Enterococcus cloaca	Subhepatic and periportal abscesses	Perforated appendix/necrotic cecum	Survived on HD
18 [16]	F	34	9	E. coli, Candida, S. aureus	Fluid consistent with PD	Perforated appendicitis	Survived on HD
19 [16]	M	46	14	Clostridium difficle, C. freundii, C. albicans, S. aureus	Fluid consistent with PD	Perforated appendicitis	Death (sepsis)
20 [16]	M	57	7	E. coli (two species)	Sigmoid diverticulitis	Perforated diverticulitis	Survived on HD
21 [16]	F	70	21	E. coli, S. aureus	CT scan negative	Perforated diverticulitis	Survived on HD
22 [16]	M	80	2	Klebsiella oxytoca	CT scan negative	B-cell lymphoma of appendix	Survived, on PD

Table 2. Characteristics of Patients on PD With Peritonitis From Perforation

No.

Sex

Age (years)

Delay in diagnosis

Culture

CT scan results

Findings at surgery

Outcome

1 [14]

Multiple enteric organisms

Perforated diverticulitis

Survived

2 [14]

Multiple enteric organisms

Perforated diverticulitis

Survived

3 [14]

E. coli

Infarction right colon

Died (MI)

4 [14]

Multiple enteric organisms

Perforated diverticulitis

Died (sepsis)

5 [14]

Multiple enteric organisms

Ischemic colitis

Died (sepsis)

6 [14]

Multiple enteric organisms

Perforated diverticulitis (autopsy)

Died (MI)

7 [14]

Multiple enteric organisms

Perforated diverticulitis

Survived

8 [15]

E. coli, Pseudomonas aeruginosa

Appendicitis

Survived, on HD

9 [15]

E. coli

Tubo-ovarian abscess

Survived, on PD

10 [15]

E. coli

Perforated sigmoid diverticulitis

Survived, on HD

11 [15]

2.5

E. coli

Perforated gastric cancer

Survived on HD

12 [15]

E. coli

Perforated Sigmoid diverticulitis

Survived on HD

13 [15]

E. coli

Mesenteric Infarct

Died

14 [15]

E. coli, anaerobes

Cecal perforation and colonic infarct

Died

15 [15]

E. coli, Clostridium, Anaerobes

Perforated sigmoid diverticulitis

Survived on HD

16 [15]

E. coli, Anaerobes

Small bowel infarction

Died (on table)

17 [15]

Pseudomonas, Candida albicans, Enterococcus cloaca

Subhepatic and periportal abscesses

Perforated appendix/necrotic cecum

Survived on HD

18 [16]

E. coli, Candida, S. aureus

Fluid consistent with PD

Perforated appendicitis

Survived on HD

19 [16]

Clostridium difficle, C. freundii, C. albicans, S. aureus

Fluid consistent with PD

Perforated appendicitis

Death (sepsis)

20 [16]

E. coli (two species)

Sigmoid diverticulitis

Perforated diverticulitis

Survived on HD

21 [16]

E. coli, S. aureus

CT scan negative

Perforated diverticulitis

Survived on HD

22 [16]

Klebsiella oxytoca

CT scan negative

B-cell lymphoma of appendix

Survived, on PD