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Published on: February 19, 2019

Spontaneous fungal peritonitis in patients with hepatitis B virus-related liver disease

V Cleophas1, V George, M Mathew

  • 1Department of Gastroenterology & Hepatology, C.M.C. Hospital, Vellore, Tamil Nadu, India.

Journal of Clinical Gastroenterology
|July 29, 2000
PubMed

Insights

Spontaneous fungal peritonitis is rare, even in non-immunocompromised patients. This study highlights two cases of Cryptococcus neoformans peritonitis in hepatitis B virus-infected individuals, suggesting increased clinical suspicion is warranted.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Mycology

Background:

  • Spontaneous bacterial peritonitis is a common complication in cirrhotic ascites.
  • Fungal peritonitis is a rare complication, particularly in human immunodeficiency virus (HIV)-negative or non-immunocompromised individuals.

Observation:

  • Two cases of spontaneous fungal peritonitis are presented.
  • The causative fungal isolate in both cases was Cryptococcus neoformans.
  • Both patients had a history of hepatitis B virus (HBV) infection.

Findings:

  • The clinical and laboratory presentations of these fungal peritonitis cases mimicked conventional spontaneous bacterial peritonitis.
  • Isolation of fungus in pure culture from ascitic fluid is uncommon, especially in non-immunocompromised hosts.

Implications:

  • Heightened clinical suspicion for fungal peritonitis is recommended in patients with cirrhotic ascites, especially those with HBV infection.
  • This case series broadens the understanding of rare fungal infections in liver disease patients.
  • Early diagnosis and appropriate antifungal treatment are crucial for managing spontaneous fungal peritonitis.

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