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Paecilomyces variotii in peritoneal dialysate
A Marzec1, L G Heron, R C Pritchard
1Department of Medical Microbiology, Austin Hospital, Melbourne, Victoria, Australia.
Abstract:
Four cases of peritonitis caused by the filamentous fungus Paecilomyces variotii in patients on continuous ambulatory peritoneal dialysis are reported. Removal of the Tenckhoff catheter and antifungal chemotherapy led to resolution of symptoms in all cases. Possible contaminating events are discussed, and reported infections with P. variotii are reviewed.
Insights
Peritonitis from Paecilomyces variotii is a rare complication in patients undergoing continuous ambulatory peritoneal dialysis. Prompt catheter removal and antifungal treatment effectively resolved infections in four reported cases.
Area of Science:
- Mycology
- Infectious Diseases
- Nephrology
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is a common treatment for end-stage renal disease.
- Peritonitis is a serious complication of CAPD, often caused by bacteria.
- Fungal peritonitis is less common but can be associated with significant morbidity.
Observation:
- Four cases of peritonitis caused by Paecilomyces variotii in CAPD patients were identified.
- Paecilomyces variotii is a filamentous fungus.
- All patients presented with symptoms of peritonitis.
Findings:
- Removal of the Tenckhoff catheter was a crucial step in managing the infection.
- Systemic antifungal chemotherapy was administered to all patients.
- All four patients experienced complete resolution of peritonitis following treatment.
Implications:
- Paecilomyces variotii should be considered in the differential diagnosis of fungal peritonitis in CAPD patients.
- Early diagnosis and combined treatment (catheter removal and antifungal therapy) are essential for successful outcomes.
- Understanding potential sources of contamination is important for preventing future cases.