رجل عمره ٥٢ سنة يعمل غسيلاً بريتونياً في البيت منذ سنة. جاء لأن السائل الخارج صار عكراً، ومعه ألم في البطن وحرارة ٣٨٫٣. مكان القسطرة نظيف. الضغط ١٢٤/٧٨، والنبض ١٠٢. ما الأرجح؟

A 52-year-old man has done peritoneal dialysis at home for a year. He presents because the effluent has become cloudy, with abdominal pain and T 38.3 °C. The exit site is clean; BP 124/78, HR 102. What is most likely?

1. Peritoneal dialysis-associated peritonitis
2. Constipation preventing drainage of the fluid
3. Fluid overload from drinking too much water
4. Normal fluid leakage around the catheter site

Answer: A) Peritoneal dialysis-associated peritonitis. Cloudy effluent with abdominal pain and fever indicates PD peritonitis. Send fluid for cell count and culture; antibiotics are usually given intraperitoneally.