Peritonitis due to Aspergillus and zygomycetes in patients undergoing peritoneal dialysis: report of 2 cases and review of the literature.
Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) has been associated with high mortality and high CAPD-discontinuation rates. Most cases are due to Candida spp. while Aspergillus spp. and zygomycetes have only rarely been implicated. We report one case each of CAPD-related peritonitis caused by Aspergillus terreus and Mucor sp., which have previously been described in the literature once and twice, respectively. The former had a slowly progressive course, did not respond to amphotericin B (AB), and died; the latter improved after a prolonged course of liposomal-AB. Among reported cases of CAPD-related peritonitis due to molds (22 Aspergillus spp. and seven zygomycetes), previous bacterial peritonitis was a common event, the related mortality associated with Aspergillus and zygomycetes was 27% and 57%, respectively, prompt removal of the Tenckoff catheter was critical for survival, and most patients were not able to resume CAPD.
Nannini
Esteban C
EC
Division of Infectious Diseases, Department of Internal Medicine, The University of Texas Medical School, Houston, Texas, USA. Esteban.C.Nannini@uth.tmc.edu
Paphitou
Niki I
NI
Ostrosky-Zeichner
Luis
L
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D005500:Follow-Up Studies; D005658:Fungi / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D009181:Mycoses / Q000175:diagnosis / Q000188:drug therapy; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects* / Q000379:methods; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D018570:Risk Assessment; D016896:Treatment Outcome
D000935:Antifungal Agents