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Acremonium kiliense peritonitis complicating continuous ambulatory peritoneal dialysis: report of two cases
Abstract:
Two cases of peritonitis caused by Acremonium kiliense in patients receiving a continuous ambulatory peritoneal dialysis treatment are reported. Diagnosis was established by direct examination and cultures of dialysis effluent, secretion of catheter-exit-site and from the tip of the catheter. Management of fungal peritonitis includes catheter removal, since in this infection the result of systemic antifungal therapy is inconsistent.
Insights
Two cases of peritonitis caused by Acremonium kiliense in continuous ambulatory peritoneal dialysis (CAPD) patients were reported. Catheter removal is crucial for managing this fungal infection due to inconsistent systemic antifungal therapy outcomes.
Area of Science:
- Nephrology
- Infectious Diseases
- Mycology
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is a common renal replacement therapy.
- Fungal peritonitis is a serious complication in CAPD patients, often associated with poor outcomes.
- Acremonium kiliense is a rare fungal pathogen causing opportunistic infections.
Observation:
- Two CAPD patients developed peritonitis attributed to Acremonium kiliense.
- Diagnosis involved analyzing dialysis effluent, catheter-exit-site secretions, and catheter tips.
- Clinical presentation included signs and symptoms of peritonitis.
Findings:
- Acremonium kiliense was identified as the causative agent in both cases.
- Microscopic examination and fungal cultures confirmed the diagnosis.
- Treatment strategies were evaluated based on diagnostic findings.
Implications:
- Fungal peritonitis necessitates prompt diagnosis and management in CAPD patients.
- Catheter removal is a critical component of treatment for Acremonium kiliense peritonitis.
- Systemic antifungal therapy alone may yield inconsistent results, highlighting the importance of device management.