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Related Experiment Videos

Cryptococcal peritonitis in patients on peritoneal dialysis.

J W Smith1, W C Arnold

  • 1Department of Medicine, University of Arkansas for Medical Sciences, Little Rock 72205.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|May 1, 1988
PubMed
Summary

Cryptococcus neoformans peritonitis is rare in patients on peritoneal dialysis. Early diagnosis and treatment with IV amphotericin B and catheter removal are crucial for cryptococcal infection management.

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Mycology

Background:

  • Peritonitis from Cryptococcus neoformans is uncommon, particularly in end-stage renal disease (ESRD) patients undergoing peritoneal dialysis (PD).
  • Cryptococcal infections can present insidiously, especially in immunocompromised individuals.

Observation:

  • Two cases of cryptococcal peritonitis in patients on chronic peritoneal dialysis are presented.
  • The initial sign of infection in both patients was positive dialysate cultures for Cryptococcus neoformans.
  • One patient had systemic lupus erythematosus treated with prednisone; the other had type I diabetes mellitus and severe malnutrition.
  • Both patients were diagnosed with cryptococcal meningitis.

Findings:

  • Prompt diagnosis of cryptococcal peritonitis via dialysate cultures is essential.

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  • Treatment involves intravenous (IV) amphotericin B and removal of the peritoneal dialysis catheter.
  • Concurrent cryptococcal meningitis requires thorough investigation and management.

    • Implications:

    • This highlights the importance of considering cryptococcal infections in PD patients presenting with peritonitis, even without typical risk factors.
    • Aggressive management, including antifungal therapy and catheter removal, is vital for patient outcomes.
    • Further research into risk stratification and early detection of cryptococcosis in PD populations is warranted.