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Peritonitis due to Rhizopus in a patient undergoing continuous ambulatory peritoneal dialysis

M H Branton1, S C Johnson, J D Brooke

  • 1Department of Medicine, Walter Reed Army Medical Center, Washington, D.C. 20307-5001.

Reviews of Infectious Diseases
|January 1, 1991
PubMed

Insights

A patient on continuous ambulatory peritoneal dialysis (CAPD) developed Rhizopus peritonitis, a rare fungal infection. Prompt treatment with amphotericin B was initiated, but the patient later died from unrelated causes.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Mycology

Background:

  • End-stage renal disease (ESRD) patients undergoing continuous ambulatory peritoneal dialysis (CAPD) are susceptible to infections.
  • Peritonitis is a known complication of CAPD, often bacterial, but fungal causes are less common.

Observation:

  • A 61-year-old male ESRD patient on CAPD developed peritonitis.
  • The causative agent was identified as Rhizopus, a rare fungal pathogen in this context.
  • The infection onset followed a change in catheter disinfection technique.
  • Key risk factors like hyperglycemia, acidemia, deferoxamine use, and Elastoplast dressings were absent.

Findings:

  • The patient was treated with amphotericin B, and the CAPD catheter was removed.
  • An autopsy revealed active Rhizopus infection with abscesses and ileal wall invasion.
  • The patient's death was attributed to unrelated causes, not the fungal infection.

Implications:

  • This case highlights Rhizopus peritonitis as a rare but serious complication of CAPD.
  • Changes in CAPD catheter care protocols may influence infection risk.
  • Fungal peritonitis requires prompt diagnosis and antifungal therapy.

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