Rhodococcus equi in CAPD-associated peritonitis treated with azithromycin.

A 74-year-old man presented with a 1-day history of abdominal pain and cloudy dialysis fluid. Fifty years previously he had had a left orchidectomy and an inguinal hernia repair had been performed because of an undescended testis. Five years later he was found to have a left hydronephrosis requiring nephrectomy. He had psoriasis and a mild polyarthropathy. Fifteen years before this presentation he was noted to have impaired renal function, which declined until he required haemodialysis. Two years prior to admission a Tenckhoff catheter had been inserted and CAPD begun. Two episodes of peritonitis due to coliform organisms had responded to intraperitoneal antibiotics. At presentation his only medication was aluminium hydroxide.