Possible Chemical Peritonitis Due to Using Cool Peritoneal Dialysate Fluid: A Case Report

Sterile peritonitis have been reported dependent on some agents such as icodextrin, vancomycin, and amphotericin B. We have reported a case of sterile peritonitis which was not related with these agents. The patient who had been on continuous ambulatory peritoneal dialysis for six months developed abdominal pain after using peritoneal dialysis fluid without heating. Her complaints had started immediately after that. The patient admitted to the hospital for peritonitis and initial analysis of the dialysate revealed 2000 cell/mm3 (PMNL). Intraperitoneal ceftazidime has been started and the patient’s abdominal pain decreased immediately and subsequent analysis of the dialysate showed no cells in 24 hours after the treatment. This quick response of acute peritonitis can be related with cold usage of peritoneal dialysis fluid. Therefore, chemical peritonitis secondary to the usage of cool peritoneal dialysis might be the diagnosis in our case. In conclusion, the physical factors that effect the peritoneal membrane, such as cold usage of peritoneal dialysis fluid, should be considered in the diagnosis of culture negative peritonitis.