Culture-negative peritonitis secondary to splenic infarcts in peritoneal dialysis: Case report and literature review
Bibliographic record
Abstract
This case report describes a 66-year-old male on continuous cycling peritoneal dialysis (PD) with polycythemia vera and type 2 diabetes. He presented with culture-negative PD-associated peritonitis secondary to splenic infarcts and further accompanied by a splenic vein thrombosis and posterior brain circulation infarcts. His abdominal pain was atypical for peritonitis, being mild and localized to the left side, with an unremitting course despite several treatment attempts with appropriate antimicrobial coverage. An extensive workup for thromboembolic causes was unremarkable. Initially, the patient was started on aspirin and later treated with hydroxyurea and long-term warfarin. His PD catheter was removed due to concerns about an underlying biofilm, and a new one was inserted one month later, while on temporary hemodialysis, without recurrence. This case highlights that non-infectious, culture-negative PD peritonitis related to splenic infarction should be considered in patients with left-sided abdominal pain, poor clinical response to appropriate antibiotics and significant risk factors for thromboembolic events, such as hematologic disorders like polycythemia vera and splenomegaly. Maintaining a high clinical suspicion can prevent unnecessary antibiotic use and reduce repeated exposure to intravenous contrast for imaging studies. Early initiation of long-term anticoagulation might also prevent futile PD catheter removal if subsequent clinical improvement is obtained.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".