Yoshihiro Nakamura1,*, Tsuyoshi
Watanabe1, Naoho Takizawa1, Yoshiro
Fujita1,2
1Department of Rheumatology and
2Department of Nephrology Chubu Rosai Hospital,
2-10-15, Komei-cho, Minato-ku, Nagoya, Aichi 455-8530, Japan
* Correspondence: Yoshihiro Nakamura,
Department of Rheumatology,
Chubu Rosai Hospital, 1-10-6,
Komei-cho, Minato-ku, Nagoya 455-8530, Japan
E-mails:
nakamurashift@yahoo.co.jp
(YN)
tsuyoshiwatanaberhythm@yahoo.co.jp
(TW)
ttkkzzww5959@gmail.com
(NT)
hujitay@gmail.com (YF)
Abstract
Some peritoneal dialysis catheter
infections cannot be detected via a physical examination.
Ultrasonography can aid in the diagnosis of such infections.
Keywords: peritoneal dialysis, peritoneal dialysis catheter infection,
cutaneous abscess
Peritoneal catheter tunnel
infection causes peritoneal dialysis (PD)-related peritonitis and
technical failure. It is sometimes difficult to diagnose peritoneal
catheter tunnel infection on physical examination. Therefore, if tunnel
infection is possible, ultrasonographic examination of the catheter
tunnel is recommended.1,2 We examined a 57-year-old
man on PD for 10 months exhibiting a cutaneous nodule on his abdomen. A
cutaneous nodule with skin redness was observed near the PD catheter but
was not attached to it (Figure 1). Exit site of the catheter was clear.
Ultrasonography showed a hypoechoic zone around the catheter attached to
the cutaneous nodule just under the skin, as revealed via an intense
power Doppler signal (Figure 2). Needle puncture was performed on the
nodule, and Corynebacterium spp. was detected via a pus culture.
We diagnosed a cutaneous abscess
related to the peritoneal catheter tunnel infection; subsequently,
treatment using minocycline was started, with a dose of 200 mg/day.
After two weeks, the skin lesion was completely cured. The patient
continued to take minocycline for four weeks. There was no recurrence
after minocycline discontinuation. Thus, ultrasonography can aid in the
diagnosis of PD catheter infections even if such infections cannot be
detected via a physical examination.
Author contributions
YN: served as a corresponding author and was involved in the manuscript
review, writing, and submission. TW, NT, and YF: served as co-authors
and were involved in the manuscript review.
Acknowledgement
We express our sincere thanks to Dr. Shigehisa Koide for giving us
constructive comments and warm encouragement.
Compliance with ethical standards
Conflict of interest
The authors have declared no conflict of interest exist.
Ethics approval
This article does not contain any study with human participants or
animal subjects, which was performed by any of the authors.
Informed consent
An informed consent form was signed by the patient.
Funding Details: We received no specific grants for this
work.
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Szeto,
C. C., Li, P. K., Johnson, D. W., et al. 2017. ISPD catheter-related
infection recommendations: 2017 update. Perit Dial Int 37:141–154.
Granata, A., Zeiler, M. Di Nicolo, P., et al. The underrated role of
ultrasound in peritoneal dialysis. J Ultrasound Med 2021.
https://doi.org/10.1002/jum.15710
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