Peritoneal Dialysis‐Related Mycobacterium fortuitum Exit‐Site/Tunnel Infection in a Pediatric Patient: A Case Report

TL;DR

A 25-month-old child on peritoneal dialysis recovered from a rare Mycobacterium fortuitum infection after timely treatment and catheter removal.

Contribution

This case report highlights the successful management of a rare pediatric infection with M. fortuitum during peritoneal dialysis.

Findings

M. fortuitum infection was rapidly identified and treated with multimodal antibiotics and catheter removal.

The patient had a favorable outcome with no long-term complications.

Ultrasound evaluation and early treatment were critical for recovery.

Abstract

In patients in peritoneal dialysis (PD) who develop exit site and/or catheter tunnel infections, expeditious identification of the causative organism and early implementation of treatment are important to ensure good outcomes. Among the many causative organisms, the diagnosis of
Mycobacterium fortuitum
is particularly challenging, with its treatment often requiring a combination of approaches, including the removal of the peritoneal catheter and the administration of multiple antibiotics. Here, we present the case of a 25‐month‐old pediatric patient on PD who developed PD‐associated tunnel infection due to
M. fortuitum
; the patient was successfully treated with multimodal antibiotics, with no sequela, following the rapid identification of the causative agent, the use of multimodal antibiotics, and PD catheter removal. In our case, the timely initiation of treatment, combined with ultrasound evaluation, was crucial for achieving a favorable outcome.

Culture‐negative ESI/TI that does not respond to standard antibiotics should be suspected for NTM infection. In patients with NTM infection, we suggest catheter removal and a multi‐combination antibiotic regimen. In our case, the timely initiation of treatment, combined with ultrasound evaluation, was crucial for achieving a favorable outcome.

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