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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.
Journal of Clinical Microbiology
|September 1, 1993
Summary
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.