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Intra-abdominal abscess caused by Rhodotorula mucilaginosa in a peritoneal dialysis patient: a case report
Shinya Abe1, Tomomi Tanaka2, Nao Matsubara3
1Department of Nephrology and Rheumatology, Nihonkai General Hospital, 30 Akiho-Cho, Sakata, Yamagata, 998-8501, Japan. shinya.abe6402@gmail.com.
Abstract:
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.
Insights
Fungal intra-abdominal abscess (IAA) is a rare complication in peritoneal dialysis (PD) patients. This case details a successful treatment of Rhodotorula mucilaginosa IAA in a PD patient.
Area of Science:
- Nephrology
- Infectious Diseases
- Mycology
Background:
- Fungal intra-abdominal abscess (IAA) is a rare but serious complication in patients undergoing peritoneal dialysis (PD).
- Rhodotorula species are infrequent opportunistic yeasts causing PD-associated peritonitis.
- Intra-abdominal abscess caused by Rhodotorula in PD patients has not been previously documented.
Purpose of the Study:
- To report a case of fungal IAA caused by Rhodotorula mucilaginosa in a patient on PD.
- To emphasize the importance of considering fungal IAA in PD patients with persistent fever during antibiotic therapy.
- To highlight the successful management of this rare infection.
Main Methods:
- Case report of a 52-year-old male patient on PD for end-stage kidney disease.
- Diagnosis of IAA due to Rhodotorula mucilaginosa was confirmed via abscess culture.
- Treatment involved open surgical drainage, PD catheter removal, and prolonged intravenous liposomal amphotericin B therapy.
Main Results:
- Successful management of Rhodotorula mucilaginosa IAA in a PD patient.
- Rhodotorula mucilaginosa was identified as the causative agent of the intra-abdominal abscess.
- Treatment with surgical drainage, catheter removal, and antifungal therapy led to a favorable outcome.
Conclusions:
- Fungal IAA should be considered in PD patients presenting with fever during antibiotic treatment for peritonitis.
- Rhodotorula species represent rare but significant pathogens in PD-associated infections.
- Prompt source control and appropriate antifungal treatment are critical for managing fungal IAA in PD patients.
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