Curvularia lunata Peritonitis in Continuous Ambulatory Peritoneal Dialysis: An Occupational Exposure at Play

This is a case report of rare fungal peritonitis caused by the dematiaceous mold Curvularia lunata in a 45-year-old gentleman, a mason by occupation, who was a hypertensive and non-diabetic, chronic kidney disease (CKD) stage 5 patient undergoing continuous ambulatory peritoneal dialysis (CAPD). This represents one of the few documented cases globally notable for its occupational exposure (soil) as a likely risk factor. This patient presented with classic symptoms of peritonitis and blackish discolouration of the transfer set of the peritoneal dialysis (PD) catheter. Diagnosis was based on the microscopic identification of distinctive curved conidia with an enlarged hyperpigmented third cell - a hallmark feature differentiating it from other fungi of the same species. Successful management required urgent catheter removal and intravenous liposomal amphotericin B. This case underscores the life-threatening nature of fungal peritonitis (mortality: 20-45%) and establishes occupational soil exposure as a risk.