Correct! An elevated dialysate white blood cell (WBC) count >100 cells/microL and/or greater than 50% polymorphonuclear leukocytes (PMNs) would be consistent with bacterial peritonitis.

This test is unlikely to give us information to help diagnose this patient’s abdominal pain. Try again!

Absolutely, these tests are crucial and should be sent as soon as possible (ideally before antibiotic therapy).

Fungal peritonitis is far less common than bacterial peritonitis in patients on PD, but it carries higher morbidity and mortality. This culture is not routinely sent unless suspicion for fungal infection is high or a patient has had culture negative peritonitis for several days.

This test is performed to assess for chylous ascites, for which we have low suspicion in this case. Try again!

Correct! Direct delivery of antibiotics to the peritoneal space is ideal, and vancomycin plus gentamicin provides good gram-positive and gram-negative coverage empirically.

While this is an option if intraperitoneal antibiotics are unavailable, direct delivery to the peritoneal space is the best approach.

Broad empiric gram-positive and gram-negative coverage should be initiated until gram stain and/or culture results have returned. Vancomycin will provide gram-positive coverage, but an additional agent should be given to cover gram-negative organisms. Try again!

Peritonitis is a serious infection, and time to antibiotic delivery is crucial. Empiric coverage should be started. Try again!

A single episode of peritonitis with a suspected bacterial infection is not an indication to remove a PD catheter. Try again!