पेरिटोनिटिस (पेरिटोनियम में संक्रमण) क्या है?

विस्तृत जानकारी

Peritonitis is the leading complication of peritoneal dialysis (PD) and a major cause of technique failure leading to transfer to hemodialysis. Diagnostic criteria per ISPD guidelines (2022 Update): two of (1) compatible clinical features (abdominal pain, cloudy effluent, fever), (2) effluent WBC count >100/μL (after dwell ≥2 hours) with >50% polymorphonuclear cells, (3) positive effluent culture. Causative organisms: gram-positive skin flora (Staphylococcus aureus, S. epidermidis) — 40-60%; gram-negative (E. coli, Pseudomonas) — 20-30%; culture-negative — 10-20%. Treatment involves empiric intraperitoneal antibiotics (vancomycin/cephalosporin + aminoglycoside) until culture results guide targeted therapy. Fungal peritonitis is rare but carries high mortality (30-50%) and requires catheter removal. Prevention: strict exit site care, connectology (UV Flash, double bag systems), monthly culture surveillance, and patient re-training every 6 months.

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