A Case of Refractory Peritoneal Dialysis-Related Peritonitis Caused by Streptococcus gordonii

An 82-year-old woman undergoing peritoneal dialysis (PD) presented to our hospital with cloudy PD effluent since four days. The leukocyte count in the effluent was elevated to 2900/μL, and the patient was diagnosed with PD-related peritonitis. Treatment with cefazolin and ceftazidime was initiated; however, the leukocyte count in the effluent did not improve. Culture of the effluent revealed the presence of <i>Streptococcus gordonii</i>. Treatment was switched to ampicillin monotherapy; however, when the leukocyte count in the effluent still did not normalize, the PD catheter was removed for management of refractory PD-related peritonitis, which was then cured. <i>S. gordonii</i> can form biofilms, suggesting that PD-related peritonitis may develop through the formation of biofilms on the catheter, leading to refractory peritonitis.