Related Experiment Videos
[Fungal peritonitis during continuous ambulatory peritoneal dialysis (CAPD)]
P García-Martos1, J Díaz Portillo, M A Pérez Ruilópez
1Seccion de Microbiología, Hospital del SAS, Cádiz.
Abstract:
We report three cases of fungal peritonitis in patients undergoing CAPD, representing 1.3% of 228 episodes recorded during an 8 year period. The three patients, who had been catheterized for a long time, had previous episodes of bacterial peritonitis and had received antibiotic therapy. The culture was decisive to make the diagnosis. The change of the catheter and the treatment with antifungal agents contributed to cure the infection, although the three patients died from other causes. One case of peritonitis was caused by Candida lusitaniae.
Insights
Fungal peritonitis is a rare complication in continuous ambulatory peritoneal dialysis (CAPD) patients. Early diagnosis via culture and antifungal treatment are crucial for managing this infection.
Area of Science:
- Nephrology
- Infectious Diseases
- Mycology
Context:
- Continuous ambulatory peritoneal dialysis (CAPD) is a common treatment for end-stage renal disease.
- Peritonitis is a known complication of CAPD, with bacterial infections being most common.
- Fungal peritonitis is a less frequent but serious complication, particularly in long-term catheterized patients with prior antibiotic exposure.
Purpose:
- To report three cases of fungal peritonitis in CAPD patients.
- To highlight the incidence, diagnosis, and management of fungal peritonitis in this population.
- To discuss the causative agents and outcomes of fungal peritonitis.
Summary:
- Three cases of fungal peritonitis occurred over an 8-year period in 228 CAPD episodes (1.3% incidence).
- Patients had long-term catheterization, previous bacterial peritonitis, and antibiotic therapy.
- Diagnosis was confirmed by culture; treatment involved catheter exchange and antifungal agents, leading to infection resolution, though patients later died from unrelated causes. One case involved Candida lusitaniae.
Impact:
- This study underscores the importance of considering fungal etiologies in CAPD peritonitis, especially in high-risk patients.
- Culture-based diagnosis and prompt antifungal therapy are vital for successful management.
- While fungal peritonitis can be treated, patient outcomes are influenced by underlying conditions and comorbidities.