To report a case of peritoneal dialysis-associated peritonitis caused by Coxiella burnetii and evaluate the use of omadacycline as a treatment option based on the case findings.
Approach:
Case Presentation: A 62-year-old male with recurrent PDAP unresponsive to empirical antibiotics was treated with omadacycline as part of a multi-agent regimen after identification of C. burnetii through metagenomic next-generation sequencing.
Key Findings:
The patient achieved hemodynamic stability within 48 hours of starting omadacycline.
Inflammatory markers normalized progressively over the subsequent week.
The patient recovered fully and remained relapse-free during 3 months of follow-up.
Interpretation:
The case suggests that further investigation is needed to determine the role of omadacycline in treating C. burnetii infections in PDAP.
Limitations:
Concurrent broad-spectrum antibiotics and ICU support complicate definitive attribution of recovery to omadacycline.
Polymicrobial infection may influence treatment outcomes.
Conclusion:
Further studies are warranted to validate the efficacy of omadacycline in treating infections caused by C. burnetii without implying current efficacy.
