Intermediate Real-Life Case
Learning objectives: Diagnose PD peritonitis from effluent findings, obtain cultures correctly, start empiric coverage promptly, and recognize catheter or surgical complications.
Clinical Scenario
A 55-year-old woman on continuous ambulatory peritoneal dialysis presents with abdominal pain and cloudy effluent. Temperature is 38.1°C, exit-site erythema is mild, and effluent white-cell count is 1,850/µL with 88% neutrophils.
Clinical Reasoning
Send effluent cell count, differential, Gram stain, and culture before antibiotics when possible without delaying treatment. Reassess promptly for treatment failure, tunnel infection, fungal disease, or a surgical abdomen.
Interactive Checkpoints
Complete the case questions to test your clinical reasoning. Detailed explanations are revealed after completion.