Peritoneal mucormycosis in a patient receiving continuous ambulatory peritoneal dialysis.
A 48-year-old man receiving maintenance hemodialysis for 3 years and continuous ambulatory peritoneal dialysis for 1 year developed a clinical picture compatible with peritonitis. Three successive fluid cultures were negative, and only after filtration of a large volume of peritoneal fluid a fungus identified as a Rhizopus sp was isolated in cultures of the filtering devices. The same fungus was also isolated from the peritoneal catheter cuff. Intravenous amphotericin B was administered and both the abdominal and general conditions of the patient improved transiently. Twenty days after initiation of antifungal treatment, a clinical suspicion of intestinal perforation arose and an exploratory laparotomy was scheduled, but the patient died during the anesthetic induction. The patient never received deferoxamine; any conditions predisposing to mucormycosis, such as diabetes or immunosuppression, were also absent.
Polo
J R
JR
Department of General Surgery, Hospital General Gregorio Marañon, Madrid, Spain.
Luño
J
J
Menarguez
C
C
Gallego
E
E
Robles
R
R
Hernandez
P
P
D000666:Amphotericin B / Q000627:therapeutic use; D001202:Ascitic Fluid / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000188:drug therapy / Q000209:etiology*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000209:etiology* / Q000382:microbiology; D012233:Rhizopus / Q000302:isolation & purification
D000666:Amphotericin B