[CIS-PAGID] peritonitis in a PD patient

[Richard Wasserman]

I have been asked to evaluate a two year old who has been on peritoneal
dialysis since 12 days of age because of recurrent peritonitis with unusual
organisms. Cultures have grown Xylosoxidans, gamma hemolytic strep,
pseudomonas, strep viridans, strep pneumoniae, group b strep, staph aureus.
Most recently, the staph aureus peritonitis disseminated and he had an
associated osteomyelitis of the knee and several inflammed lymph nodes one
of which grew staph aureus on biopsy. He has never had sinusitis, pneumonia
or a cutaneous abscess. There have been a few episodes of otitis media.

IgA [H] 126 mg/dL (24-121), IgG 846 mg/dL (533-107), IgM 73 mg/dL (26-218).
Neutrophil oxidative burst assay showed 94% of cells positive (transport
control was 83%).

I'd don't know that there are additional tests that will contribute.
Suggestions?
Thanks,
Richard Wasserman

-- 
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788
Fax (972) 566-8837
Cell (214) 697-7211
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