# Repeated Peritonitis in a Peritoneal Dialysis Patient: An Unusual Case of Bacillus licheniformis With Vancomycin Failure Despite Sensitivity

## TL;DR

A peritoneal dialysis patient experienced repeated peritonitis caused by Bacillus licheniformis, which was sensitive to vancomycin but still failed to respond.

## Contribution

Highlights a rare case of recurring B. licheniformis peritonitis with vancomycin treatment failure despite sensitivity.

## Key findings

- Patient had three episodes of B. licheniformis peritonitis over six months.
- Vancomycin failed to treat the infection despite in vitro sensitivity.
- Case underscores the need for accurate identification and tailored treatment strategies.

## Abstract

Bacillus licheniformis (B. licheniformis) is an aerobic, gram-positive, spore-forming rod typically found in soil, decaying organic matter, vegetables, and water, and occasionally part of normal gut flora. This report highlights a case of unusual repeated peritonitis caused by B. licheniformis, with three episodes occurring over six months, all of which were sensitive to vancomycin yet presented an unclear cause for recurrence. Peritonitis represents a significant cause of mortality, hospitalization, and failure of peritoneal dialysis catheters, leading to forced transitions to hemodialysis. The rarity of B. licheniformis as a pathogen in human infections emphasizes the critical need for precise microbial identification and customized therapeutic strategies.