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.
Division of Infectious Diseases, Department of Internal Medicine, The University of Texas Medical School, Houston, Texas, USA. Esteban.C.Nannini@uth.tmc.edu
Esteban C
EC
Nannini
Niki I
NI
Paphitou
Luis
L
Ostrosky-Zeichner
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