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Acremonium spp. peritonitis in an infant

Tanil Kendirli1, Ergin Ciftçi, Mesiha Ekim

  • 1Pediatric Intensive Care Unit, Ankara University School of Medicine, Ankara, Turkey. tanilkendirli@hotmail.com

Mycoses
|April 22, 2008
PubMed

Insights

Fungal peritonitis is a serious complication in children undergoing peritoneal dialysis. This case highlights Acremonium spp. as a rare cause, successfully treated with catheter removal and liposomal amphotericin B.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Medical Mycology

Background:

  • Fungal peritonitis is a rare but severe complication in pediatric patients undergoing peritoneal dialysis (PD).
  • Candida species are the most common fungal agents, often leading to significant morbidity and mortality.
  • Treatment can be challenging, necessitating a high index of suspicion for early diagnosis and management.

Observation:

  • A 7-month-old infant with Down syndrome, congenital heart disease, pulmonary hypertension, and congestive heart failure required PD for edema and hyponatremia.
  • The infant developed Acremonium spp. peritonitis despite receiving broad-spectrum antibiotics and fluconazole.
  • This presentation underscores the potential for non-Candida fungal infections in immunocompromised pediatric patients on PD.

Findings:

  • Acremonium spp. was identified as the causative agent of peritonitis in this infant.
  • Successful treatment involved the removal of the peritoneal dialysis catheter and administration of liposomal amphotericin B.
  • This case demonstrates an effective therapeutic strategy for a rare fungal peritonitis etiology.

Implications:

  • Highlights Acremonium spp. as a potential, albeit rare, cause of fungal peritonitis in pediatric PD patients.
  • Emphasizes the need for considering a broader range of fungal pathogens beyond Candida in refractory or unusual cases.
  • Suggests that aggressive management, including catheter removal and targeted antifungal therapy, is crucial for favorable outcomes in pediatric fungal peritonitis.

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