Intraperitoneal streptokinase use-associated eosinophilic peritonitis

Eosinophilic peritonitis (EP) is an uncommon complication of peritoneal dialysis, which happens usually secondary to either an underlying bacterial, fungal or tubercular infection or as a reaction to intraperitoneal drugs or constituents of the dialysis system like tubings or solution. We report a case of a middle aged male who was initiated on continuous ambulatory peritoneal dialysis. Because of inadequate inflow and outflow of dialysis fluid, he was given two doses of intraperitoneal streptokinase after ruling out other causes. After the use of intraperitoneal streptokinase, there was turbid effluent with culture showing Staphylococcus aureus. Even after the successful treatment of bacterial peritonitis with intravenous antibiotics, he continued to have turbid effluent, with a predominance of eosinophils in the effluent cell count. A diagnosis of EP was made and he was managed with the antihistaminic drug loratidine, with complete resolution.