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- W2166722090 abstract "Patients on peritoneal dialysis are at increased risk for peritonitis. Peritonitis following endoscopy, both with and without polypectomy, is a known complication for patients on CAPD. We report a case of a 50 year-old man with end-stage renal disease (ESRD) on continuous ambulatory peritoneal dialysis (CAPD) who developed coagulase negative staphylococcus peritonitis within 24 hours of upper endoscopy with biopsy and colonoscopy with polypectomy. He had a previous history of peritonitis unrelated to invasive procedures and eventually was transitioned to hemodialysis because of his recurrent peritonitis. Review of the literature identifies nine previously reported cases of patients on CAPD who developed peritonitis following endoscopic procedures (Table 1). One retrospective study found that prophylactic antibiotics significantly reduced peritonitis in patients on CAPD following invasive non-EGD procedures. The International Society for Peritoneal Dialysis (ISPD) guidelines recommend prophylactic antibiotics for patients of CAPD undergoing endoscopic procedures. However, gastroenterology guidelines do not address this issue. It is important to re-evaluate the use of prophylactic antibiotics in patients on CAPD undergoing endoscopic procedure, especially as gastroenterologists and nephrologists may differ in their approach regarding these patients. As no controlled studies exist, this merits an opportunity for further study of the role of antibiotics in peritoneal dialysis patients undergoing endoscopy. Understanding patient factors that may play a role in who is at risk may help risk stratify this population and prevent unnecessary complications. Table 1Peritonitis following colonoscopy with and without polypetcomy in patients on continuous ambulatory peritoneal dialysis Author/Reference Age/Sex Duration of CAPD Indication for Colonoscopy Polypectomy Time to Infection Cultured Microorganism(s) Prophylaxis Given Previous History of Peritonitis Noted Peterson (1987) 69/M __ Follow-up previously seen polyps - 36 hrs E. coli - + Verger (1987) 65/M 1 year Rectal bleeding + 24 hrs E. coli - - Holley (1987) 69/F __ Positive Hemoccult + 24 hrs E. coli - - Sprenger (1987) 54/F 1 year Positive Hemoccult + 72 hrs Enterococcus +* - Ray (1990) 65/F __ Rectal bleeding + 24 hrs Nonfragilis Bacteroides (4 species) +** - Bac (1994) 51/F 4 years Fecal blood loss + 24 hrs P. asaccharolyticusB. disensB. ureolyticus - - Poortviet[1] (2010) 67/F 4 years Rectal bleeding + 48 hrs E. coli - + Poortviet [2] (2010) 73/M “years” Rectal bleeding + 48 hrs E. coliK. oxytoceaEnterococcacea - - Lin (2012) 53/F 4 years History of colonic polyps and elevated CEA + 24 hrs E. coliK. pneumoniaeE. faecalis - - *Intraperitoneal cephalothin; **Intravenous vancomycin and gentamycin Open table in a new tab *Intraperitoneal cephalothin; **Intravenous vancomycin and gentamycin" @default.
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- W2166722090 date "2015-05-01" @default.
- W2166722090 modified "2023-09-27" @default.
- W2166722090 title "Su1517 A Case of Peritonitis Following Endoscopy in a Patient on CAPD With Review of the Literature: a Call to Reconcile Gastroenterology and Nephrology Guidelines" @default.
- W2166722090 doi "https://doi.org/10.1016/j.gie.2015.03.478" @default.
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