Peritonitis caused by Ewingella americana in a patient with peritoneal dialysis: A case report

Introduction. Peritonitis can happen in patients undergoing continuous ambulatory peritoneal dialysis. It is commonly caused by Staphylococcus aureus, which is the basis of the empiric choice of antibiotics. Here we report a case that was caused by Ewingella americana and thus required different considerations of treatment. Case presentation. A 76-year-old Chinese woman underwent continuous ambulatory peritoneal dialysis after the diagnosis of chronic renal failure. She presented with generalized abdominal pain after the start of continuous ambulatory peritoneal dialysis for 10 consecutive months. The pathogen was identified as Ewingella americana by microbiological examination and its susceptibility to antibiotics was partly different from the common pathogens causing peritonitis. The change of antibiotic treatment from vancomycin to amikacin accelerated her recovery. Conclusion: It should be noted that peritonitis can be caused by E. americana. Our report may add to the known causes of peritonitis in a hospital environment. With respect to the empiric choice of antibiotics to treat peritonitis under the condition of continuous ambulatory peritoneal dialysis, it is worth noting that E. americana has a different susceptibility to the spectrum of antibiotics and its corresponding therapy should be taken into consideration.