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Septicemia, Necrotizing Fasciitis, and Peritonitis Due to Vibrio Vulnificus Treated With Early Use of Polymyxin B Hemoperfusion in a Patient Undergoing CAPD: A Case Report

Authors
 Jae Young Kim  ;  Young Su Joo  ;  Sangmi Lee  ;  Ji Young Lee  ;  Jung Tak Park  ;  Seong Hyeok Han  ;  Tae-Hyun Yoo  ;  Shin-Wook Kang 
Citation
 BMC NEPHROLOGY, Vol.21(1) : 127, 2020-04 
Journal Title
 BMC NEPHROLOGY 
Issue Date
2020-04
Keywords
Hemoperfusion ; Peritoneal dialysis ; Peritonitis ; Polymyxin B immobilized fiber ; Septicemia ; Vibrio vulnificus
Abstract
Background: Vibrio vulnificus infection is a rare but fatal foodborne illness. Here, we report a case of Vibrio vulnificus peritonitis followed by severe septicemia in a patient undergoing continuous ambulatory peritoneal dialysis (CAPD) who was treated with hemoperfusion using polymyxin B immobilized fiber. Case presentation: A 63-year-old man undergoing CAPD was admitted to the emergency room due to general weakness, fever, and abdominal pain with hazy dialysate. Two days before admission, he had eaten raw fish. Initial laboratory tests including peritoneal fluid analysis suggested peritonitis. Despite empirical intraperitoneal antibiotic treatment, his fever did not subside, and multiple vesicles on the extremities newly appeared. The result of initial peritoneal fluid culture and blood cultures reported Vibrio vulnificus as the most likely causative pathogen. Hemoperfusion with polymyxin B immobilized fiber was performed to control gram-negative bacterial septicemia with antibiotics targeting the pathogenic organism. The patient recovered completely and was discharged without complications. Discussion and conclusion: Suspicion of Vibrio vulnificus infection in susceptible immunocompromised patients is important for early diagnosis and prompt management. Peritonitis should be noted as a clinical manifestation of Vibrio vulnificus infection in CAPD patients, and polymyxin B hemoperfusion along with proper antibiotics could be considered as a treatment option.
DOI
10.1186/s12882-020-01772-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Jae Young(김재영)
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Sangmi(이상미) ORCID logo https://orcid.org/0000-0002-3619-0809
Joo, Young Su(주영수) ORCID logo https://orcid.org/0000-0002-7890-0928
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/176161
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