Fungal peritonitis is a rare, potentially lethal, complication of continuous ambulatory peritoneal dialysis (CAPD). We report what we believe to be the first confirmed Neosartorya hiratsukae CAPD-related peritonitis case in Europe. The patient died, despite early removal of the peritoneal catheter and antifungal therapy. This report highlights the impact of emerging fungal pathogens and the importance of early diagnosis on the outcome in CAPD-related fungal peritonitis.

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Background. Lipoprotein(a), Lp(a), has been recognized as an atherogenic and thrombogenic lipoprotein in the general population and in hemodialysis (HD) patients. In addition, fibrinogen and fibronectin may promote atherothrombosis. The aim of this study was to investigate any possible relationship between Lp(a) and thrombogenic coagulation proteins in non-diabetic HD patients. Patients and Methods. Serum Lp(a) and plasma fibrinogen, plasminogen, and fibronectin levels were measured pre-HD in 60 uremic patients (30 male, 30 female) aged 58.6 AE 8.0 years who had been receiving HD treatment for 61.3 AE 50.7 months. The control group comprised 20 age-and sex-matched healthy subjects. All patients were receiving erythropoietin treatment. Results. The mean serum Lp(a) (33.88 AE 34.12 mg/dL) and plasma fibrinogen (329.45 AE 80.62 mg/dL) levels were significantly higher in the HD patients compared with those in the controls (16.70 AE 10.36 and 254.00 AE 43.34 mg/dL, respectively; p < .05 and p < .001, respectively). Plasminogen levels did not differ between the HD patients (11.64 AE 3.22 mg/dL) and the control group (10.67 AE 1.41 mg/dL, p>.05). Fibronectin levels were slightly increased in the HD patients (33.96 AE 5.49 mg/dL) versus in the control group (30.9 AE 5.80 mg/dL, p < .05). There was a significant positive correlation between Lp(a) and fibrinogen levels (r ¼ 0.305, p < .02), as well as between Lp(a) and fibronectin levels (r ¼ 0.360, p < .01). Moreover, there was a significant positive correlation between fibrinogen and fibronectin levels (r ¼ 0.587, p < .0001). Conclusions. According to our results, in non-diabetic HD patients, abnormal serum Lp(a) levels significantly correlated with abnormal levels of fibrinogen and fibronectin. There is a concern that the relationship between these atherogenic and thrombogenic acute-phase proteins may contribute to the increased incidence of atherosclerotic cardiovascular disease in this patient population.