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Topical antifungal treatment cures exit-site fungal infection
Wen-Ding Hsu1, Shuei-Liong Lin, Felin-Lin Wu
1Nephrology Section, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Abstract:
Exit-site fungal infection, although rarely reported, may be a critical complication in patients on peritoneal dialysis. There is no optimal treatment of exit-site fungal infection. We report four cases of exit-site infection with Candida parapsilosis. Four-week treatment with topical sulconazole cream was administered. Fungal infection was cured in all patients but followed by exit-site bacterial infection in two patients. The topical application of sulconazole cream is recommended for exit-site fungal infection.
Insights
Topical sulconazole cream effectively treated exit-site fungal infections in peritoneal dialysis patients. While fungal infections were cured, two patients later developed bacterial infections, suggesting careful monitoring is needed post-treatment.
Area of Science:
- Mycology
- Infectious Diseases
- Nephrology
Background:
- Exit-site fungal infections are rare but serious complications in patients undergoing peritoneal dialysis (PD).
- Optimal treatment strategies for these infections remain undefined.
- Candida species are a common cause of fungal infections in healthcare settings.
Observation:
- This study reports on four PD patients experiencing exit-site infections specifically caused by Candida parapsilosis.
- All patients received a four-week course of topical sulconazole cream for their fungal infection.
- Clinical outcomes were monitored for resolution of fungal infection and incidence of secondary bacterial infections.
Findings:
- Topical sulconazole cream demonstrated complete efficacy in eradicating Candida parapsilosis exit-site infections in all four patients.
- Two out of the four patients subsequently developed secondary bacterial exit-site infections following the fungal infection treatment.
- The study highlights the potential for a two-step infectious process at the PD exit site.
Implications:
- Topical sulconazole cream is a viable and recommended treatment option for exit-site fungal infections in PD patients.
- The occurrence of secondary bacterial infections warrants close patient monitoring after successful fungal treatment.
- Further research may explore preventative strategies against secondary bacterial infections post-antifungal therapy.