How do you manage a patient on peritoneal dialysis who develops a single episode of cloudy effluent with a low cell count and no organisms on Gram stain while remaining clinically well?

What is your initial management approach when a peritoneal dialysis patient presents with a single episode of cloudy effluent, negative Gram stain, low cell count, and no systemic symptoms?

• Start empiric intraperitoneal antibiotics immediately, given that cloudy effluent should be presumed infectious until proven otherwise
• Investigate for non-infectious causes such as chemical peritonitis, hemoperitoneum, or eosinophilic peritonitis before initiating antibiotics
• Send cultures and observe closely without antibiotics given the low cell count and absence of systemic symptoms
• Repeat the effluent cell count and culture before making a treatment decision
• Other