Forgotten intrauterine device inducing aseptic peritonitis in newly started peritoneal dialysis

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Abstract

Infectious peritonitis is a challenging condition to continuing peritoneal dialysis (PD) in many end-stage renal disease patients. A cloudy peritoneal effluent or abdominal pain is the most common symptoms of peritonitis, which would be confirmed with peritoneal leukocytosis. However, not all cloudy effluent and peritoneal leukocytosis are infectious in etiology. Here, we report a case of peritoneal leukocytosis related to a forgotten intrauterine device (IUD), where antibiotic therapy failed to achieve a clinical change. This case report and literature review provides insight into a rare but significant presentation of aseptic peritonitis and highlights the need to consider IUD interaction with PD dialysate as a reason for aseptic peritonitis.
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遗忘宫内节育器诱导新开始腹膜透析的无菌性腹膜炎
感染性腹膜炎是许多终末期肾脏疾病患者继续腹膜透析(PD)的一个挑战。腹膜流出物混浊或腹痛是腹膜炎最常见的症状,可由腹膜白细胞增多症证实。然而,并非所有的排出物混浊和腹膜白细胞增多在病因上都是传染性的。在这里,我们报告一例腹膜白细胞增多症与遗忘宫内节育器(IUD)有关,抗生素治疗未能实现临床改变。本病例报告和文献回顾提供了一种罕见但重要的无菌性腹膜炎的表现,并强调需要考虑宫内节育器与PD透析液的相互作用是无菌性腹膜炎的原因。
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