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Fungal peritonitis caused by Curvularia lunata in a patient undergoing peritoneal dialysis
J Guarner1, C Del Rio, P Williams
1Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia.
Abstract:
The authors present a case of a patient undergoing continuous ambulatory peritoneal dialysis (CAPD) who developed peritonitis with Curvularia lunata and gram negative Enterobacteriaceae. A review of the literature indicates that human infections caused by Curvularia are uncommon despite the ubiquity of the organism in the environment. In this case, the organism was present in the Tenckhoff catheter, lacking attachment to it, but obstructing the flow. Treatment of fungal peritonitis during CAPD is discussed.
Insights
A rare fungal infection, Curvularia lunata, caused peritonitis in a patient on continuous ambulatory peritoneal dialysis (CAPD). The organism obstructed the catheter, highlighting challenges in managing uncommon infections during dialysis.
Area of Science:
- Nephrology
- Infectious Diseases
- Medical Mycology
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is a common treatment for end-stage renal disease.
- Peritonitis is a serious complication of CAPD, often caused by bacterial infections.
- Fungal peritonitis, though less common, poses a significant challenge in CAPD patients.
Observation:
- A CAPD patient presented with peritonitis involving Curvularia lunata and gram-negative Enterobacteriaceae.
- Curvularia lunata, a ubiquitous environmental fungus, rarely causes human infections.
- The organism was found within the Tenckhoff catheter, obstructing flow without apparent attachment.
Findings:
- This case highlights an unusual presentation of fungal peritonitis in a CAPD patient.
- Curvularia lunata can cause significant morbidity in immunocompromised individuals undergoing CAPD.
- The presence of the fungus within the catheter lumen impeded dialysis fluid exchange.
Implications:
- Early diagnosis and appropriate treatment are crucial for managing fungal peritonitis in CAPD.
- This case underscores the importance of considering uncommon pathogens in refractory peritonitis.
- Further research into the pathogenesis and treatment of fungal peritonitis in CAPD patients is warranted.