Mucormycosis peritonitis: more than 2 years of disease-free follow-up after posaconazole salvage therapy after failure of liposomal amphotericin B.
A 57-year-old woman with end-stage kidney disease secondary to autosomal dominant polycystic kidney disease developed peritoneal dialysis-related Mucor peritonitis after her pet cockatoo bit through her transfer set. The infection persisted despite more than 8 weeks of treatment with liposomal amphotericin B. On a compassionate basis, she then received oral posaconazole, 800 mg/d, in divided doses for 6 months. She experienced complete remission and has remained disease free since then, for more than 2 years. We review the medical literature about mucormycosis peritonitis which, albeit rare, carries very high mortality. The treatment of choice is liposomal amphotericin B, which failed in our patient. Our case report suggests that posaconazole is an attractive treatment option in patients with peritoneal dialysis-related Mucor peritonitis.
Sedlacek
Martin
M
Dartmouth School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756-0001, USA. martin.sedlacek@hitchcock.org
Cotter
John G
JG
Suriawinata
Arief A
AA
Kaneko
Thomas M
TM
Zuckerman
Richard A
RA
Parsonnet
Jeffrey
J
Block
Clay A
CA
D000666:Amphotericin B / Q000008:administration & dosage*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy*; D008081:Liposomes; D008875:Middle Aged; D009091:Mucormycosis / Q000188:drug therapy* / Q000209:etiology; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications*; D017211:Treatment Failure; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*
D000935:Antifungal Agents; D008081:Liposomes; D014230:Triazoles; C101425:posaconazole; D000666:Amphotericin B