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Successful treatment of Aspergillus peritonitis complicating peritoneal dialysis

K Prewitt1, J Lockard, D Rodgers

  • 1Nephrology Service, Fitzsimons Army Medical Center, Aurora, CO 80045-5001.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|June 1, 1989
PubMed

Insights

Aspergillus peritonitis is a rare complication of peritoneal dialysis. This case study details the first successful management of Aspergillus peritonitis, allowing patients to continue dialysis.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Mycology

Background:

  • Fungal peritonitis is a rare but serious complication in patients undergoing peritoneal dialysis (PD).
  • Aspergillus species are infrequent causes of fungal peritonitis in PD patients, with limited reported cases.
  • Previous cases of Aspergillus peritonitis have had poor outcomes, with high mortality and inability to continue PD.

Observation:

  • This report presents the first documented case of dialysis-related Aspergillus peritonitis where the patient successfully continued peritoneal dialysis.
  • The case involved a patient experiencing Aspergillus peritonitis during PD treatment.
  • A review of four previously reported cases of dialysis-related Aspergillus peritonitis was conducted.

Findings:

  • The successful management of Aspergillus peritonitis in this case allowed for the continuation of peritoneal dialysis, a novel outcome.
  • Intravenous amphotericin B and dialysis catheter removal were identified as key therapeutic interventions.
  • Analysis of previous cases suggests limited treatment success and poor prognosis for Aspergillus peritonitis in PD patients.

Implications:

  • This case suggests that aggressive treatment with intravenous amphotericin B and dialysis catheter management may enable PD continuation in select Aspergillus peritonitis cases.
  • The findings offer new therapeutic insights for managing this uncommon but severe PD complication.
  • Further research is warranted to optimize treatment strategies for fungal peritonitis in peritoneal dialysis patients.

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