Candida Cholecystitis in a Diabetic Patient on Chronic Peritoneal Dialysis

Abstract

To examine the antiparkinsonian effects of blocking glycineB receptors, we designed a pilot study testing the potent and selective antagonist, PAMQX, in 1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine‐treated primates. PAMQX had no intrinsic effects but markedly potentiated the antiparkinsonian action of levodopa. In a dose‐dependent fashion, coadministration of the glycineB antagonist with levodopa extended the response duration by nearly 60%. It is noteworthy that PAMQX, within a considerable dose range, did not cause ataxia or other side effects. These data indicate that blocking N‐methyl‐D‐aspartate receptors selectively to manipulate dopaminergic‐mediated motor responses may be produced effectively by glycineB antagonists. Ann Neurol 2004

Candida peritonitis in dogs: report of 5 cases

“…Many studies of peritonitis in people have shown that patients with positive bacterial culture had a higher mortality rate than those with sterile culture, and that those patients with both bacterial and fungal organisms present in peritoneal fluid had an even higher number of fatalities than those with bacteria alone . In people, the association of Candida with cholecystitis similar to case 1 in our study is 100% lethal . Furthermore, while most patients with Candida peritonitis have concurrent bacterial sepsis, in some cases fungal sepsis is present as a sole entity, similar to case 4 in our study, which is associated with morbidity and mortality …”

“…Antimicrobial use, which allows fungal overgrowth by altering the intestinal microflora, is consistently identified as a risk factor in human studies. These opportunistic pathogens can spread to the peritoneum when there is disruption of the mucosal barrier resulting from conditions such as surgery, perforation, inflammation, or neoplasia …”

“…Other commonly reported species include C parapsilosis, C tropicalis, and C krusei . In people, C glabrata is considered difficult to treat and is often resistant to many azoles, including fluconazole, which is usually the first line of treatment for invasive fungal infections. Our case 5, in which C glabrata was isolated alone, was treated with intravenous fluconazole and responded to treatment.…”

“…Other less common inciting causes of Candida peritonitis in people include pancreatitis, appendicitis, diverticulitis, diabetes mellitus, and penetrating trauma. Most notably, the majority of cases of Candida peritonitis were receiving systemic, broad‐spectrum antimicrobial therapy at the time of diagnosis …”