[CIS-PAGID] peritonitis in a PD patient

[Richard Wasserman]

He has a normal inflammatory response with fever and leukocytosis. I was
thinking about TLR pathways but the absence of any other infections was a
question.
Richard Wasserman

On Mon, Jun 20, 2011 at 8:57 AM, Jyonouchi, Soma C <JYONOUCHI at email.chop.edu

> wrote:



>  Any problems mounting fevers or elevations of inflammatory markers?  I

> typically also think of TLR pathway defects (IRAK4, MyD88, NEMO) with

> disseminated gram+ve and –ve organisms.  A TLR assay may be useful.  ****

>

> ** **

>

> Best, ****

>

> ** **

>

> SJ****

>

> ** **

>

> *From:* pagid-bounces at list.clinimmsoc.org [mailto:

> pagid-bounces at list.clinimmsoc.org] *On Behalf Of *Richard Wasserman

> *Sent:* Monday, June 20, 2011 9:53 AM

> *To:* PAGID

> *Subject:* [CIS-PAGID] peritonitis in a PD patient****

>

> ** **

>

> 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****

>




-- 
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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