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Published on: June 27, 2017
A case of peritonitis caused by Rhizopus microsporus
Abstract:
We report a case of a 62-year-old female patient who developed peritonitis after receiving a renal transplant. Candida glabrata was detected and treated with voriconazole. As the patient did not improve under therapy, laparotomy was performed. Mould-like plaques were found on the peritoneum. Using culture as well as pan-fungal polymerase chain reaction (PCR) followed by DNA microarray hybridisation of the amplicon, the causative agent was identified as Rhizopus microsporus. Despite aggressive surgical treatment, intravenous therapy with amphotericin B and topical administration of Lavasept (polyhexamethylenbiguanide), the patient died.
Insights
A renal transplant patient developed peritonitis caused by Rhizopus microsporus, a mould. Despite extensive treatment including antifungal drugs and surgery, the patient succumbed to the infection.
Area of Science:
- Medical Mycology
- Transplant Surgery
- Infectious Diseases
Background:
- Post-renal transplant infections pose significant risks.
- Fungal peritonitis is a rare but serious complication.
- Early and accurate diagnosis is crucial for patient outcomes.
Observation:
- A 62-year-old female presented with peritonitis following a renal transplant.
- Initial treatment for Candida glabrata with voriconazole was ineffective.
- Laparotomy revealed mould-like plaques on the peritoneum.
Findings:
- Pan-fungal polymerase chain reaction (PCR) and DNA microarray identified Rhizopus microsporus as the causative agent.
- The patient received aggressive surgical and medical management, including amphotericin B and Lavasept.
- Despite comprehensive treatment, the patient did not survive.
Implications:
- This case highlights the challenge of diagnosing and treating rare fungal infections post-transplant.
- Rhizopus microsporus should be considered in refractory peritonitis cases after transplantation.
- Advanced diagnostic techniques like PCR and DNA microarray are vital for identifying unusual pathogens.
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