Aspergillus peritonitis in a lupus patient on chronic peritoneal dialysis

Area of Science:

• Nephrology
• Infectious Diseases
• Rheumatology

Background:

• Systemic lupus erythematosus (SLE) can lead to end-stage renal disease (ESRD), necessitating renal replacement therapy like continuous ambulatory peritoneal dialysis (CAPD).
• Patients with ESRD and compromised immune systems are at increased risk for infections, including rare fungal peritonitis.

Observation:

• A female CAPD patient with SLE-related ESRD developed fungal peritonitis.
• The causative agent identified was Aspergillus fumigatus, an uncommon pathogen in this clinical setting.

Findings:

• The patient survived the fungal peritonitis following treatment with amphotericin B.
• Surgical removal of the dialysis catheter was a critical part of the treatment protocol.
• The rare occurrence of Aspergillus fumigatus peritonitis was potentially linked to the patient's underlying SLE, ESRD, and immunosuppressive treatments.

Implications:

• This case underscores the importance of considering rare fungal pathogens in CAPD peritonitis, especially in immunocompromised patients with autoimmune diseases like SLE.
• Aggressive treatment including antifungal therapy and catheter removal is crucial for favorable outcomes.
• Further research may be warranted to understand the specific risk factors and optimal management strategies for fungal peritonitis in ESRD patients with complex comorbidities.