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Peritoneal dialysis complicated by Aspergillus flavus peritonitis: a role for fungal antigen serodiagnosis
Abstract:
A patient is described with aspergillus peritonitis associated with peritoneal dialysis. Although the diagnosis was established by exploratory laparotomy, aspergillus antigenemia was detected retrospectively in sera obtained 15 days prior to the surgical procedure. An approach to the evaluation of a patient with culture negative peritonitis and the potential clinical usefulness of the detection of fungal antigen in serum and peritoneal fluid of patients undergoing peritoneal dialysis is discussed.
Insights
Aspergillus peritonitis in peritoneal dialysis patients can be diagnosed retrospectively using fungal antigen tests. Early detection of Aspergillus antigenemia may aid in managing culture-negative peritonitis.
Area of Science:
- Nephrology
- Infectious Diseases
- Medical Mycology
Background:
- Peritonitis is a serious complication in patients undergoing peritoneal dialysis (PD).
- Culture-negative peritonitis presents diagnostic challenges, potentially delaying appropriate antifungal treatment.
- Aspergillus species are opportunistic fungi that can cause severe infections, including peritonitis.
Observation:
- A case of Aspergillus peritonitis in a patient on peritoneal dialysis is presented.
- Diagnosis was confirmed via exploratory laparotomy.
- Aspergillus antigenemia was retrospectively identified in serum samples collected 15 days before surgery.
Findings:
- Retrospective detection of Aspergillus antigenemia in serum samples predated the definitive diagnosis.
- This suggests that fungal antigen detection may serve as an early diagnostic marker.
- The study highlights the potential for antigenemia to indicate invasive fungal infection in PD patients.
Implications:
- Discusses an approach to evaluating patients with culture-negative peritonitis.
- Highlights the potential clinical utility of detecting fungal antigens in serum and peritoneal fluid.
- Emphasizes the importance of considering fungal infections in PD peritonitis, especially when cultures are negative.