Morganella morganii (M. Morganii) is a Gram-negative rod that is part of the normal flora in humans. However, M. Morganii is a rare cause of PD-related peritonitis. A 78-year-old woman with end-stage renal disease secondary to diabetes mellitus on Automated Peritoneal Dialysis (PD) admitted with abdominal pain and cloudy peritoneal fluid. After performing a peritoneal fluid culture, the patient was treated with intraperitoneal (IP) antibiotics. On hospital day 4, a culture of the peritoneal fluid revealed M. Morgani. Although IP antibiotics injection had lasted in the home, however, on 9th day after discharge, effluent peritoneal fluid became cloudy again. Further laboratory tests showed an elevated peritoneal WBC count. We considered the antibiotic treatment to have failed due to bacterial colonization of the surface of the peritoneal Tenckhoff catheter. Therefore, we decided to remove the catheter, and switch the treatment regimen to haemodialysis. Subsequent intraperitoneal cultures were identified as M. Morganii with the same sensitivity as before. Our patient may be first case of PD related peritonitis by M. morganii in Republic of Korea.
Kyeong Min Kim, Jong Ho Shin, Jin Uk Jeong and Kitae Bang
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