Background: Listeria monocytogenes is a rare cause of peritonitis, usually occurring in the setting of cirrhosis or immunosuppression. Bortezomib manufacturer There are 12 published cases of Listeria monocytogenes peritoneal

dialysis peritonitis in the literature. The 10 patients on continuous ambulatory peritoneal dialysis and 2 with unknown method of peritoneal dialysis were all treated with intravenous or intraperitoneal antibiotics. We report a case occurring in an automated peritoneal dialysis patient, successfully treated with oral antibiotics. Methods: An 87 year old, non-immunosuppressed end-stage renal failure patient on automated peritoneal dialysis, presented with abdominal pain, bloating and diarrhoea after consuming a meal of sushi. She was systemically well and commenced

on empiric outpatient antimicrobial therapy with intraperitoneal vancomycin 2 g and gentamicin 80 mg. Peritoneal dialysate gram stain demonstrated gram positive rods, subsequently culture positive for Listeria monocytogenes. Her antibiotic therapy was changed to amoxicillin 1 g every eight hours orally and she completed total of 22 days of therapy. Her abdominal discomfort resolved and her peritoneal dialysate BMS354825 cleared. Results: Repeat dialysate culture one week following completion of antibiotic therapy confirmed resolution of peritonitis. Conclusions: Oral antimicrobial therapy may be effective in treatment of Listeria monocytogenes peritoneal dialysis peritonitis in the systemically well patient. 292 UNUSUAL BLEEDING

IN THIN GLOMERULAR BASEMENT MEMBRANE DISEASE A LEE, J SEVASTOS St Vincent’s Hospital, Sydney, NSW, Australia Aim: We present a case of thin glomerular basement membrane (GBM) disease with unusual manifestations of haematuria, haemoptysis and peritoneal bleeding. Background: Thin GBM disease is caused by a defect of collagen, occasionally Rebamipide associated with loin pain haematuria syndrome. It is considered a disease affecting only the renal tract. There are only few case reports of haemoptysis associated with this condition but there is no literature suggesting bleeding elsewhere. Methods: A young patient presented age 16 with recurrent severe abdominal pain over many months. Laparoscopy for appendicectomy demonstrated no appendicitis but a small amount of blood was found in the pelvis. She subsequently developed intermittent macroscopic haematuria. Cystoscopy showed mild to moderate mucosal bladder erythema and trabeculation, possibly interstitial cystitis. Repeat laparoscopy again noted the presence of free blood in the pelvis. There was no endometriosis and sexually transmitted infection screen was negative. Endoscopy revealed moderate chronic fundal gastritis and colonoscopy to investigate rectal bleeding found a rectal hyperplastic polyp.