Aeromonas peritonitis.

Five new cases of peritonitis caused by Aeromonas species are reported, and 29 others described in the literature are reviewed. Males predominated (71%), and the mean age was 56.9 years. Acquisition was nosocomial in 20% of the cases. All patients except one (3%) had significant underlying diseases; 73% had chronic hepatic disease, 15% had chronic renal failure (treated with chronic ambulatory peritoneal dialysis [CAPD]), and 9% had an intestinal perforation. Symptoms were similar to those of peritonitis caused by other pathogens, with the exception of diarrhea, which occurred in 25% of cases. Blood cultures were positive in 74% of the cases. The species isolated were Aeromonas hydrophila (27), Aeromonas sobria (5), and Aeromonas caviae (2). The overall case-fatality rate was 57%. Three strains were resistant to cotrimoxazole. Aeromonas species should be taken into account as a cause of peritonitis in patients with cirrhosis or who are undergoing CAPD.