Intra-abdominal abscess caused by Rhodotorula mucilaginosa in a peritoneal dialysis patient: a case report

Fungal intra-abdominal abscess (IAA) is an uncommon but serious complication in patients undergoing peritoneal dialysis (PD). Although Rhodotorula species are rare opportunistic yeasts known to cause PD-associated peritonitis, IAA due to Rhodotorula in PD patients has not been previously reported. We report the case of a 52-year-old man on PD for end-stage kidney disease who developed an IAA caused by Rhodotorula mucilaginosa (R. mucilaginosa). New-onset fever during intraperitoneal antibiotic therapy for bacterial peritonitis led to the identification of an IAA, and R. mucilaginosa was isolated from the abscess culture. The infection was successfully managed with open surgical drainage, removal of the PD catheter, and intravenous liposomal amphotericin B for 14 weeks. This case highlights the importance of considering the possibility of fungal IAA when PD patients develop fever during antibiotic therapy for peritonitis. Clinicians should recognize Rhodotorula species as rare but clinically significant pathogens in PD-associated infections. In cases with abscess formation, timely source control and appropriate antifungal therapy are crucial for favorable outcomes.