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Trichoderma viride peritonitis
Abstract:
A patient with renal failure secondary to amyloidosis and undergoing continuous ambulatory peritoneal dialysis had fungal peritonitis due to Trichoderma viride, an organism ubiquitous in the soil. Tissue invasion by this species has not previously been reported. In vitro susceptibility of the organism suggests that such infections may respond to amphotericin B or ketoconazole although our patient died before a response to therapy could be evaluated.
Insights
A rare fungal peritonitis caused by Trichoderma viride occurred in a patient with kidney failure undergoing peritoneal dialysis. This soil fungus, typically non-invasive, led to a fatal infection, highlighting potential treatment challenges.
Area of Science:
- Mycology
- Nephrology
- Infectious Diseases
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for end-stage renal disease.
- Amyloidosis can lead to renal failure, necessitating dialysis.
- Fungal peritonitis is a serious complication of peritoneal dialysis.
Observation:
- A patient with renal failure due to amyloidosis on CAPD developed peritonitis.
- The causative agent was identified as Trichoderma viride, a soil-dwelling fungus.
- Tissue invasion by Trichoderma viride in humans had not been previously documented.
Findings:
- The patient experienced fungal peritonitis, a rare but severe complication.
- Trichoderma viride demonstrated susceptibility to amphotericin B and ketoconazole in vitro.
- Despite in vitro susceptibility, the patient's outcome was fatal before therapeutic response could be assessed.
Implications:
- This case highlights the potential for ubiquitous soil fungi like Trichoderma viride to cause invasive infections.
- Early diagnosis and appropriate antifungal therapy are crucial for managing fungal peritonitis in dialysis patients.
- Further research is needed to understand the pathogenicity and treatment strategies for Trichoderma viride infections.