Fulminant sclerosing peritonitis immediately following acute bacterial peritonitis

Sclerosing peritonitis (SP) is an uncommon disease in the peritoneal dialysis population, but the considerable morbidity and mortality associated with it make early diagnosis and treatment imperative. We describe a case illustrating that a fulminant variant of SP can occur as a second phase phenomenon immediately following treatment of acute bacterial peritonitis, a setting in which the diagnosis may be masked and aggressive immunosuppression considered potentially hazardous. Treatment with corticosteroid alone appears particularly effective for SP occurring in this setting.