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Cryptococcal peritonitis in peritoneal dialysis patients: a case report
1Department of Medicine, University of Rochester, New York 14642.
Clinical Nephrology
|April 1, 1994
Summary
Cryptococcal peritonitis in patients on peritoneal dialysis is rare but serious. This case highlights the need to screen for systemic Cryptococcus neoformans infection and manage immunosuppression carefully.
Area of Science:
- Nephrology
- Infectious Diseases
- Mycology
Background:
- Peritonitis is a significant complication for patients undergoing chronic peritoneal dialysis.
- Fungal peritonitis presents treatment challenges, with Cryptococcus neoformans peritonitis being exceptionally rare.
Observation:
- A case of Cryptococcus neoformans peritonitis occurred in a diabetic patient receiving prednisone and azathioprine for suspected chronic inflammatory demyelinating polyneuropathy.
- The patient exhibited systemic infection with C. neoformans, confirmed by cultures in cerebrospinal fluid and urine, and high blood cryptococcal antigen titers.
Findings:
- Despite catheter removal, immunosuppression withdrawal, and systemic antifungal treatment, the patient died nine weeks post-diagnosis.
- Autopsy revealed disseminated cryptococcosis affecting the lungs, spleen, and brain.
Implications:
- Cryptococcal peritonitis in peritoneal dialysis patients necessitates a thorough investigation for systemic C. neoformans infection.
- Management may require extended antifungal therapy and careful consideration of immunosuppressive medications.