Peritoneal Dialysis-associated Peritonitis: Early Detection with ¹⁸ F-Fluorodeoxyglucose PET/CT

Peritonitis is a common and serious complication of peritoneal dialysis (PD). We present the case of a 39-year-old man in a PD program who suffered a septic shock of unknown origin. 18 F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) was performed to find the source of infection after clinical improvement and prolonged antibiotic therapy. PET/CT revealed several abdominopelvic hypermetabolic foci consistent with PD-associated peritonitis, but it was not confirmed neither by clinical evaluation nor peritoneal fluid culture. Twelve days later, the patient developed clinical symptoms compatible with peritonitis, and subsequent dialysis effluent culture was positive for Streptococcus vestibularis.