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Dialysis-Related Spontaneous Bacterial Peritonitis

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1. Dialysis-Related Spontaneous Bacterial Peritonitis

Dialysis-Related Spontaneous Bacterial Peritonitis Dialysis-Related Spontaneous Bacterial Peritonitis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Dialysis-Related Spontaneous Bacterial Peritonitis Dialysis-Related Spontaneous Bacterial Peritonitis Aka: Dialysis-Related Spontaneous Bacterial Peritonitis II. Incidence Once in 15 patient-months of III. Causes Complication of Common epidermidis Other Pseudomonas aeruginosa Candida Gram-negative bowel flora s IV. Risk Factors Immunocompromised state Frequent daily dialysate exchanges Biofilm formation Hot and humid weather V. Symptoms VI. Signs with peritoneal signs may be present VII

2018 FP Notebook

2. Dialysis-Related Spontaneous Bacterial Peritonitis

Dialysis-Related Spontaneous Bacterial Peritonitis Dialysis-Related Spontaneous Bacterial Peritonitis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Dialysis-Related Spontaneous Bacterial Peritonitis Dialysis-Related Spontaneous Bacterial Peritonitis Aka: Dialysis-Related Spontaneous Bacterial Peritonitis II. Incidence Once in 15 patient-months of III. Causes Complication of Common epidermidis Other Pseudomonas aeruginosa Candida Gram-negative bowel flora s IV. Risk Factors Immunocompromised state Frequent daily dialysate exchanges Biofilm formation Hot and humid weather V. Symptoms VI. Signs with peritoneal signs may be present VII

2015 FP Notebook

3. Catheter removal, adjunct therapies and timing of reinsertion of peritoneal dialysis catheter after peritonitis

peritonitis, defined as failure of the effluent to clear after 5 days of appropriate antibiotics, should be managed by removal of the catheter to protect the peritoneal membrane for future use (Evidence). Indications for Catheter Removal for Peritoneal Dialysis-Related Infections Refractory peritonitis Relapsing peritonitis Refractory exit-site and tunnel infection Fungal peritonitis Catheter removal may also be considered for - Repeat peritonitis - Mycobacterial peritonitis - Multiple enteric organisms (...) on Peritoneal Dialysis. European Best Practice Guidelines for Peritoneal Dialysis. 3 Peritoneal access. Nephrol Dial Transplant 2005; 20 (Suppl 9): ix8–ix12. 35. Li PK-T, Szeto CC, Piraino B, et al. ISPD Guidelines/Recommendations. Peritoneal dialysis- related infections. Recommendations: 2010 update. Perit Dial Int 2010; 30: 393–423. The CARI Guidelines – Caring for Australasians with Renal Impairment Peritonitis Treatment and Prophylaxis (January 2014) Page 10 APPENDICES Table 1. Characteristics

2014 KHA-CARI Guidelines

4. Practice Guidelines for the Diagnosis and Management of Aspergillosis Full Text available with Trip Pro

disseminated infection, we recommend treatment with voriconazole in addition to evaluation for a primary focus of infection (strong recommendation; low-quality evidence) . 56. In cases of aspergillosis in burns or massive soft tissue wounds, surgical debridement is recommended, in addition to antifungal therapy (strong recommendation; moderate-quality evidence) . What Are the Treatment Recommendations for Aspergillus Peritonitis? Recommendation 57. We recommend prompt peritoneal dialysis catheter removal (...) is indicated Cutaneous aspergillosis Similar to IPA Similar to IPA Surgical resection is indicated where feasible Aspergillus peritonitis Similar to IPA Similar to IPA Removal of peritoneal dialysis catheter is essential Empiric and preemptive antifungal therapy For empiric antifungal therapy, Liposomal AmB (3 mg/kg/day IV), caspofungin (70 mg day 1 IV and 50 mg/day IV thereafter), micafungin (100 mg day), voriconazole (6 mg/kg IV every 12 h for 1 day, followed by 4 mg/kg IV every 12 h; oral therapy can

2016 Infectious Diseases Society of America

5. Canadian Society of Transplantation consensus guidelines on eligibility for kidney transplantation Full Text available with Trip Pro

of the abnormal kidneys postnatally may compress the stomach, resulting in feeding difficulties, or may compress the diaphragm causing respiratory compromise. Optimum management in this case is either unilateral or bilateral nephrectomy. , , Evaluation for transplantation may also require consideration of nephrectomy to allow sufficient space for a young child recipient to accommodate an adult donor allograft. Infections Recommendations Patients should be free of active infection, whether of viral, bacterial (...) function (Grade A). Peritonitis, tunnel infections and vascular access-related infections in patients on peritoneal or hemodialysis should be fully treated before transplantation. There are no data to recommend an optimum infection-free interval before transplantation, but documentation of the eradication of infection after completion of antibiotic therapy is appropriate (Grade C). Transplant candidates should be screened for exposure to mycobacteria with a careful clinical history, chest radiography

2005 CPG Infobase

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