Therapy of Candida peritonitis: penetration of amphotericin B into peritoneal fluid

Candida albicans peritonitis developed in a 48-year-old man with a perforated gastric ulcer who subsequently was treated with intravenous amphotericin B. The drug penetrated well into the inflamed peritoneal cavity and eradicated the organism from the peritoneal fluid. Nevertheless, at post-mortem, Candida organisms were demonstrated in a gall-bladder empyema and within the gall-bladder wall. Because intra-abdominal organs may be involved in Candida peritonitis, the use of high dose amphotericin B administered either intravenously, intraperitoneally, or both intravenously and intraperitoneally is recommended.