Successful treatment of Candida infections in peritoneal dialysis patients: case reports and review of the literature.
Infections with Candida species have been associated with significant morbidity and mortality in peritoneal dialysis (PD) patients. Such infections include peritonitis and exit-site infections attributable to Candida species, disseminated candidiasis in immunocompromised patients, and Candida esophagitis. In peritonitis and exit-site infections, both success and failure have been reported with commercially available medications. In disseminated candidiasis and Candida esophagitis, successful treatment and patient recovery depend on the overall nutritional and immune state of the patient. One case each of peritonitis and exit-site infection with non Candida albicans species were successfully treated with oral voriconazole. No literature currently exists on the use of this new product in dialysis patients. Presented here is a treatment strategy that resulted in maintenance of PD in the home setting and catheter survival following completion of treatment. A review of the English-language literature shows mixed outcomes associated with continuation of PD during treatment for Candida infection in PD patients. In conclusion, a commercially available product can be used to successfully treat PD patients who have Candida infections and to maintain the PD catheter for PD.
Kleinpeter
Myra A
MA
Tulane University Health Sciences Center, Section of Nephrology, New Orleans, Louisiana 70112, USA. mkleinp@tulane.edu
D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000188:drug therapy* / Q000209:etiology; D002408:Catheters, Indwelling / Q000009:adverse effects; D002437:Cefazolin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology; D011743:Pyrimidines / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D002437:Cefazolin; D065819:Voriconazole