Brevundimonas vesicularis Peritonitis in a Chronic Peritoneal Dialysis Patient

Gram-negative peritonitis in chronic peritoneal dialysis patients is difficult to treat and may result in catheter loss. Brevundimonas vesicularis is a Gram-negative rod bacterium which rarely causes infections in humans. A 41-year-old male receiving continuous cycling peritoneal dialysis for 5 months developed culture-negative peritonitis. He failed initial empiric treatment with intraperitoneal vancomycin and levofloxacin and thereafter intravenous gentamicin. B. vesicularis resistant to levofloxacin was isolated from the peritoneal fluid 21 days after his initial symptoms. Despite treatment with intravenous ceftriaxone and oral amoxicillin-clavulanate, the infection persisted, which required removal of the peritoneal catheter in order to cure this infection. We describe the features of B. vesicularis infection in our patient and the rarely reported additional cases.