Catheter-related peritonitis is common but rarely caused by fungal infection. We report the first case of PD patients with catheter-related peritonitis form
Aureobasidium pullulans
, a black yeast-like dematiaceous fungus, and reviewing the relevant literatures. A potential cause of this infection is poor hand hygiene and improper fingernail care. The infection could be prevented if patient and caregiver strictly follow hand-washing protocols.
BackgroundGalactomannan index (GMI) at a level higher than 0.5 provides high sensitivity and specificity for the diagnosis of fungal peritonitis. Here, we report the false-positive of GMI in peritoneal dialysis (PD) effluent (PDE) due to Rhodococcus peritonitis in PD patients.Case presentationGMI in PDE of case #1 and case #2 were 1.53 and 0.76, respectively, while serum GMI of both cases was less than 0.5. In addition, GMI from the specimens obtained directly from the stationary phase of Rhodococcus colonies were 1.27 and 1.56, which were isolated from case #1 and #2, accordingly.ConclusionHigh GMI in PDE of PD patients is not specific just for fungal infections but may also be secondary to other infections, such as Rhodococcus spp., especially in endemic areas.
This is the first human infection caused by
Hyphopichia burtonii
, resulting in peritonitis in a patient on peritoneal dialysis initially diagnosed as sterile peritonitis, resulting in delayed diagnosis and treatment. This pathogen posed a challenging diagnosis, causing low-grade peritonitis and difficulty to culture with standard bacterial broth. Moreover, automated platforms for pathogenic yeast identification could not specify the species, but broad-range PCR targeting rDNA followed by DNA sequencing successfully solved the etiology.
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