MedBugs: SAQ #626

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Case: PD Peritonitis

A 62-year-old woman with end-stage kidney disease managed with long-term continuous ambulatory peritoneal dialysis (CAPD) presents to the Emergency Department with 24 hours of worsening abdominal pain and nausea. She is seen by a junior doctor who reports that her peritoneal dialysis effluent has appeared cloudy since this morning.

She is otherwise independent and usually manages her dialysis at home.

Her vitals on presentation are:

BP 110/68 mmHg
HR 102 bpm
RR 18/min
SpO₂ 98% on room air
T 38.1°C

Abdominal examination reveals generalised tenderness without guarding. Her PD catheter exit site appears clean.

He suggests this is “almost certainly PD peritonitis” and plans to give empiric antibiotics and discharge her home.

1. Describe (2) key investigations that you would perform, including what result would support a diagnosis of PD-associated peritonitis. 4 marks

2. List (2) specific treatment modalities for the most likely diagnosis, including appropriate treatment.List (2) specific treatment modalities for the most likely diagnosis, including appropriate treatment. 2 marks

You would like to discharge this lady for treatment at home.

3. List (2) possible contraindications to this plan. 2 marks

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Case: PD Peritonitis

1. Describe (2) key investigations that you would perform, including what result would support a diagnosis of PD-associated peritonitis. 4 marks

2. List (2) specific treatment modalities for the most likely diagnosis, including appropriate treatment.List (2) specific treatment modalities for the most likely diagnosis, including appropriate treatment. 2 marks

3. List (2) possible contraindications to this plan. 2 marks

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