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Spontaneous Fungal Peritonitis in Ascites of Cardiac Origin

Yuchen Wang1, Seema Gandhi2, Bashar M Attar3

  • 1Department of Internal Medicine, John H. Stroger Hospital of Cook County, Chicago, IL.

ACG Case Reports Journal
|April 8, 2017
PubMed

Insights

Spontaneous fungal peritonitis (SFP) is a severe complication. This case highlights SFP in cardiogenic ascites, challenging diagnosis and treatment beyond typical spontaneous bacterial peritonitis.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Hepatology

Background:

  • Spontaneous fungal peritonitis (SFP) is a rare but serious complication, typically seen in patients with liver cirrhosis.
  • Ascites, the accumulation of fluid in the abdominal cavity, can arise from various conditions, including liver disease and heart failure.

Observation:

  • This report details the first documented case of culture-proven SFP in a patient with cardiogenic ascites.
  • The initial presentation mimicked spontaneous bacterial peritonitis (SBP), complicating early diagnosis.

Findings:

  • The patient's ascites culture revealed *Candida glabrata*, confirming SFP.
  • Failure to respond to standard antibacterial therapy for SBP was a key indicator for further investigation.

Implications:

  • SFP should be considered in patients presenting with ascites, particularly those with cardiac or cirrhotic etiologies.
  • A lack of response or delayed response to SBP treatment warrants consideration of fungal causes.

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