A child on peritoneal dialysis developed peritonitis, presenting with symptoms like abdominal pain and cloudy dialysate. Initial cultures were negative, but subsequent 16S rRNA gene sequencing and mycobacterial culture identified Mycobacterium abscessus. The infection was successfully treated with a prolonged course of dual β-lactam combination therapy, specifically imipenem and cefoxitin, allowing the patient to remain on peritoneal dialysis. This case highlights the challenges of diagnosing and treating atypical peritonitis in pediatric patients.
Key note: Successful treatment of Mycobacterium abscessus peritoneal dialysis-associated peritonitis with dual β-lactam therapy can prevent catheter removal and preserve dialysis access.