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Posthysteroscopy fungal peritonitis in a patient on continuous ambulatory peritoneal dialysis
1Department of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin.
Abstract:
We report the first case of posthysteroscopy fungal peritonitis, which developed in a woman 11 days after she had a hysteroscopy for menorrhagia. A high vaginal swab grew Candida albicans and the same organism was cultured from the peritoneal dialysate effluent. A vaginoperitoneal communication was suspected to allow the distension medium to carry the fungus into the peritoneum. The potential use of a prophylactic local antifungal agent before hysteroscopy is discussed.
Insights
A rare case of fungal peritonitis occurred after hysteroscopy for heavy menstrual bleeding. Candida albicans spread from the vagina to the abdomen, possibly through a hidden connection, highlighting infection risks.
Area of Science:
- Gynecology
- Infectious Diseases
- Surgical Complications
Background:
- Hysteroscopy is a common gynecological procedure for diagnosing and treating uterine conditions like menorrhagia.
- Peritonitis, inflammation of the peritoneum, is a serious condition that can arise from various intra-abdominal sources.
Observation:
- A patient developed fungal peritonitis 11 days post-hysteroscopy for menorrhagia.
- Candida albicans was identified in both vaginal swabs and peritoneal dialysate effluent.
Findings:
- The case suggests a potential vaginoperitoneal communication facilitated the spread of Candida albicans.
- The distension medium used during hysteroscopy may have transported the fungus into the peritoneal cavity.
Implications:
- This report highlights a novel complication of hysteroscopy: post-procedural fungal peritonitis.
- Consideration of prophylactic antifungal agents before hysteroscopy in at-risk patients may be warranted.
- Early recognition and management are crucial for favorable outcomes in fungal peritonitis.