<i>Clostridium difficile</i> Peritonitis Complicated by Splenic Rupture and Pelvic Abscess Formation in a Patient Previously on Continuous Ambulatory Peritoneal Dialysis

Clostridium difficile ( C. difficile ) most commonly manifests as colitis ranging from a diarrheal illness to fulminant sepsis and toxic megacolon. Dialysis patients are at a uniquely increased risk of all infections, including C. difficile infection (CDI) . Peritoneal dialysis (PD) patients are at an increased risk for secondary peritonitis given (1) the disruption of the gastrointestinal barrier, allowing enteric bacteria to translocate into the peritoneal cavity and (2) the presence of the PD catheter itself, allowing a portal of entry for bacteria. We present a case of C. difficile peritonitis complicated by pelvic abscess formation and splenic rupture in a patient on PD. C. difficile causing a secondary peritonitis is an important pathology to consider in PD patients given the increasing frequency of CDI worldwide, the inherent increased risk of infection that PD carries, and the particularity of management.