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Case report: peritonitis by Penicillium spp. in a patient undergoing continuous ambulatory peritoneal dialysis

S Keceli1, I Yegenaga, N Dagdelen

  • 1Department of Microbiology and Clinical Microbiology, Medical Faculty of Kocaeli University, Kocaeli, Turkey. z.sema@mailcity.com

International Urology and Nephrology
|September 1, 2005
PubMed

Insights

Fungal peritonitis, particularly from Penicillium spp., remains a challenge in continuous ambulatory peritoneal dialysis (CAPD). Surgical drainage alongside antifungal therapy proved crucial for patient recovery.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Medical Mycology

Background:

  • Continuous ambulatory peritoneal dialysis (CAPD) is a vital treatment for end-stage renal disease.
  • Peritonitis is a significant complication of CAPD, impacting patient morbidity and mortality.
  • Fungal peritonitis presents unique challenges in management due to its severity and resistance.

Observation:

  • A case of CAPD-related fungal peritonitis caused by Penicillium spp. is presented.
  • The patient had a history of recurrent bacterial peritonitis treated with prolonged antibiotic therapy.
  • Penicillium spp. was identified in peritoneal effluent and on the Tenckhoff catheter tip.

Findings:

  • Initial treatment with catheter removal and amphotericin B did not resolve the patient's condition.
  • Magnetic Resonance (MR) imaging revealed a peritoneal collection.
  • Surgical drainage of the collection, after completing antifungal treatment, led to clinical improvement and eradication of Penicillium spp.

Implications:

  • This case highlights the complex management of fungal peritonitis in CAPD patients.
  • Aggressive and multi-modal treatment, including surgical intervention, may be necessary for refractory cases.
  • Early and accurate diagnosis of fungal species is critical for effective therapeutic strategies.

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