A patient undergoing peritoneal dialysis—a treatment that filters waste from the blood using the belly lining—developed a serious infection caused by bacteria called Listeria monocytogenes from contaminated food. This type of infection is extremely rare in dialysis patients and doesn’t show typical warning signs, making it hard to diagnose. The patient’s infection kept coming back and didn’t respond to standard antibiotics. Doctors finally cured it using a combination of three different antibiotics: Vancomycin, Amikacin, and Piperacillin Tazobactam. This case teaches doctors what to watch for and how to treat this unusual but serious complication.

The Quick Take

  • What they studied: How doctors successfully treated a rare bacterial infection in a patient receiving peritoneal dialysis (a type of kidney treatment)
  • Who participated: One older male patient who had been receiving peritoneal dialysis for four years and had multiple health conditions including diabetes, high blood pressure, heart failure, and chronic hepatitis B
  • Key finding: A three-antibiotic combination (Vancomycin, Amikacin, and Piperacillin Tazobactam) successfully cured the infection after standard antibiotics failed
  • What it means for you: If you or someone you know uses peritoneal dialysis, be careful about food safety and report unusual symptoms like cloudy fluid, fever, and belly pain immediately. This case helps doctors recognize and treat this rare but serious infection better

The Research Details

This is a case report, which means doctors documented the medical history and treatment of one specific patient. The patient was a man in his later years who had been using peritoneal dialysis for four years to manage kidney failure caused by diabetes. He also had other serious health conditions including high blood pressure, heart failure, chronic hepatitis B, and syphilis. The doctors tracked his symptoms, test results, and response to different antibiotic treatments over time.

The infection occurred after the patient ate food contaminated with Listeria monocytogenes bacteria. The patient developed symptoms including cloudy dialysis fluid, diarrhea, belly pain, chills, and fever. These symptoms appeared multiple times, suggesting the infection kept returning. The doctors tried treating him with two antibiotics (Cefazolin sodium and Ceftazidime) but these didn’t work effectively.

Eventually, the medical team switched to a three-drug antibiotic combination and successfully eliminated the infection. This case report documents the entire journey to help other doctors recognize and treat similar infections in the future.

Case reports are important because they document unusual or rare medical situations that doctors might not see often. By sharing this case, the doctors help other medical professionals around the world recognize similar infections and know which treatments work best. This is especially valuable for rare infections like Listeria in dialysis patients, which most doctors may never encounter in their careers.

This is a single case report, which is the lowest level of medical evidence. It describes what happened to one patient but cannot prove that the same treatment will work for everyone. However, case reports are valuable for documenting rare conditions and unusual treatment successes. The strength of this report comes from detailed medical documentation and the fact that it addresses a genuinely rare complication that other doctors should know about. Readers should understand this describes one patient’s experience, not a proven treatment for all similar cases.

What the Results Show

The patient initially presented with symptoms of peritonitis (infection of the belly lining), which is a known complication of peritoneal dialysis. His dialysis fluid became cloudy, and he experienced abdominal pain, fever, chills, and diarrhea. Testing identified Listeria monocytogenes as the cause of the infection, which is extremely unusual in dialysis patients.

When treated with the standard antibiotic combination of Cefazolin sodium and Ceftazidime, the infection did not improve and symptoms kept returning. This suggested the bacteria were resistant to these common antibiotics. The medical team then switched to a three-drug combination: Vancomycin, Amikacin, and Piperacillin Tazobactam.

With this new antibiotic combination, the patient’s infection finally resolved. His symptoms disappeared, his dialysis fluid cleared, and the infection did not return. This successful outcome demonstrates that this particular three-drug combination can effectively treat Listeria infections in dialysis patients, even when standard treatments fail.

An important secondary finding was that the infection source was contaminated food. This highlights the need for dialysis patients to be especially careful about food safety and proper food handling. The patient’s multiple other health conditions (diabetes, heart failure, hepatitis B, and syphilis) may have made him more vulnerable to this rare infection, suggesting that patients with weakened immune systems need extra precautions.

Listeria monocytogenes infections in peritoneal dialysis patients are extremely rare, with very few cases reported in medical literature. Most peritonitis cases in dialysis patients are caused by other bacteria like Staphylococcus or Streptococcus species. This case is notable because it represents an unusual pathogen in this patient population. The successful treatment with the three-drug combination adds to the limited knowledge about how to manage Listeria infections when they do occur in dialysis patients.

This is a single case report, so the findings apply only to this one patient. We cannot conclude that this treatment will work the same way for all patients with similar infections. The patient had multiple serious health conditions, which may have affected how his infection developed and responded to treatment. Other patients with fewer health problems might have different outcomes. Additionally, we don’t know if the patient remained infection-free long-term after treatment ended, as the report focuses on the immediate resolution of the infection.

The Bottom Line

For peritoneal dialysis patients: Practice strict food safety by thoroughly cooking foods, washing hands before eating, and avoiding foods with higher contamination risk (like unpasteurized dairy and undercooked meats). Report any symptoms like cloudy dialysis fluid, fever, belly pain, or diarrhea immediately to your doctor. For healthcare providers: Consider Listeria as a possible cause of peritonitis in dialysis patients, especially if standard antibiotics don’t work. The three-drug combination of Vancomycin, Amikacin, and Piperacillin Tazobactam may be effective for resistant Listeria infections.

This case is most relevant to people receiving peritoneal dialysis, their caregivers, and healthcare providers who treat dialysis patients. It’s particularly important for patients with weakened immune systems or multiple health conditions. General readers should understand that while this infection is extremely rare, food safety is always important, especially for people with serious health conditions.

In this case, the patient’s symptoms resolved after starting the three-drug antibiotic combination, though the exact timeline to complete resolution isn’t specified in the report. Most bacterial infections typically begin to improve within days to weeks of starting effective antibiotics, but complete resolution may take longer. Individual timelines vary based on the severity of infection and overall health.

Want to Apply This Research?

  • Dialysis patients should track daily symptoms including dialysis fluid appearance (clear vs. cloudy), body temperature, abdominal pain level (1-10 scale), and any gastrointestinal symptoms. Log these daily and alert healthcare provider immediately if fluid becomes cloudy or fever develops.
  • Set daily reminders for food safety practices: wash hands before eating, verify proper food storage temperature, avoid high-risk foods (undercooked meat, unpasteurized dairy, deli meats), and maintain a food diary to identify any potential contamination sources if symptoms develop.
  • Create a symptom alert system that flags any combination of: cloudy dialysis fluid, fever above 100.4°F, abdominal pain, or diarrhea. Set up automatic notifications to healthcare provider when these symptoms are logged. Maintain a monthly review of infection-free days and share trends with your dialysis care team.

This case report describes the experience of one patient and should not be considered medical advice or a guaranteed treatment for all similar infections. Peritoneal dialysis patients experiencing symptoms like cloudy fluid, fever, or abdominal pain should contact their healthcare provider immediately. Treatment decisions should always be made in consultation with qualified medical professionals who understand your individual health situation. While this case provides valuable information about a rare infection, individual responses to treatment vary significantly. Do not attempt to self-diagnose or self-treat based on this case report.