Peritonitis due to Aspergillus and zygomycetes in patients undergoing peritoneal dialysis: report of 2 cases and review of the literature

Diagn Microbiol Infect Dis. 2003 May;46(1):49-54. doi: 10.1016/s0732-8893(02)00554-0.

Abstract

Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) has been associated with high mortality and high CAPD-discontinuation rates. Most cases are due to Candida spp. while Aspergillus spp. and zygomycetes have only rarely been implicated. We report one case each of CAPD-related peritonitis caused by Aspergillus terreus and Mucor sp., which have previously been described in the literature once and twice, respectively. The former had a slowly progressive course, did not respond to amphotericin B (AB), and died; the latter improved after a prolonged course of liposomal-AB. Among reported cases of CAPD-related peritonitis due to molds (22 Aspergillus spp. and seven zygomycetes), previous bacterial peritonitis was a common event, the related mortality associated with Aspergillus and zygomycetes was 27% and 57%, respectively, prompt removal of the Tenckoff catheter was critical for survival, and most patients were not able to resume CAPD.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use
  • Aspergillosis / diagnosis
  • Aspergillosis / drug therapy
  • Aspergillus fumigatus / isolation & purification*
  • Follow-Up Studies
  • Fungi / isolation & purification*
  • Humans
  • Male
  • Mycoses / diagnosis
  • Mycoses / drug therapy
  • Peritoneal Dialysis, Continuous Ambulatory / adverse effects*
  • Peritoneal Dialysis, Continuous Ambulatory / methods
  • Peritonitis / drug therapy
  • Peritonitis / etiology*
  • Peritonitis / microbiology
  • Risk Assessment
  • Treatment Outcome

Substances

  • Antifungal Agents