Torulopsis glabrata Peritonitis Complicating Continuous Ambulatory Peritoneal Dialysis: Successful Management With Oral 5-Fluorocytosine

Cecchin, E; Marchi, Sergio De; Panarello, G.; Franceschin, A; Chiaradia, V.; Santini, G; Tesio, Franco

doi:10.1016/s0272-6386(84)80105-5

Cited by 19 publications

(3 citation statements)

References 15 publications

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“…Cases of FP caused by Lecythophora mutabilis (20), Bipolaris spicifera (21), Penicillium species (22,23), Roseomonas gilardii (24), Monilia sitophila (25), Histoplasma capsulatum (26), Acremonium kiliense (27), Trichoderma longibrachiatum (28), cryptococcal peritonitis (29,30), Trichosporon beigelii (31), Torulopsis glabrata (32), Rhodotorula rubra (33), Trichoderma viride (34), Exophiala jeanselmei, Drechslera spicifera , and Fusarium species (2) have also been reported in patients receiving PD. An unusual case of Rhizopus microsporus (mucormycosis) fungal infection in a teenage boy on continuous ambulatory peritoneal dialysis (CAPD) has been described (35,36).…”

Section: Causative Organisms In Fpmentioning

confidence: 99%

Fungal Peritonitis in Peritoneal Dialysis Patients

2005

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Peritonitis is one of the most frequent complications of peritoneal dialysis (PD) and 1% – 15% of episodes are caused by fungal infections. The mortality rate of fungal peritonitis (FP) varies from 5% to 53%; failure to resume PD occurs in up to 40% of patients. The majority of these FP episodes are caused by Candida species. Candida albicans has historically been reported to be a more common cause than non-albicans Candida species, but in recent reports a shift has been observed and non-albicans Candida may now be more common. Unusual, often “nonpathogenic,” fungi are being increasingly reported as etiologic agents in FP. Clinical features of FP are not different from those of bacterial peritonitis. Phenotypic identification of fungi in clinical microbiology laboratories is often difficult and delayed. New molecular diagnostic techniques ( e.g., polymerase chain reaction) are being developed and evaluated, and may improve diagnosis and so facilitate early treatment of infected patients. Abdominal pain, abdominal pain with fever, and catheter left in situ are risk factors for mortality and technique failure in FP. In programs with high baseline rates of FP, nystatin prophylaxis may be beneficial. Each program must examine its own history of FP to decide whether prophylaxis would be beneficial. Catheter removal is indicated immediately after fungi are identified by Gram stain or culture in all patients with FP. Prolonged treatment with antifungal agents to determine response and attempt clearance is not encouraged. Antifungals should be continued for 10 days to 2 weeks after catheter removal. Attempts at reinsertion should be made only after waiting for 4 – 6 weeks.

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Section: Causative Organisms In Fpmentioning

confidence: 99%

Fungal Peritonitis in Peritoneal Dialysis Patients

2005

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“…Fungal peritonitis is a serious and potentially life-threatening complication of both intermittent peritoneal dialysis and continuous ambulatory peritoneal dialysis (CAPD). Investigators reviewing significant numbers of CAPD-associated fungal peritonitis episodes cite yeasts, particularly Candida species, as the predominant etiologic agents (10,12,13,20,29,37,38,50,52,53,54,58,61,63,65,66,68,73,78). Filamentous fungi complicating CAPD, although reported less frequently and fewer in number, encompass a wide array of agents, from the classic, systemic pathogens (4,42,45) to zygomycetous species (55,64) and members of numerous moniliaceous (3,11,16,25,27,30,33,39,40,48,51,57,67,71,75,76,77) and dematiaceous genera (1,2,6,7,…”

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confidence: 99%

Fatal Hormonema dematioides Peritonitis in a Patient on Continuous Ambulatory Peritoneal Dialysis: Criteria for Organism Identification and Review of Other Known Fungal Etiologic Agents

et al. 1998

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We report a fatal case a fungal peritonitis caused by the yeast-like dematiaceous mould Hormonema dematioides in a 45-year-old woman. The woman had a 13-year history of insulin-dependent diabetes mellitus and had been on continuous ambulatory peritoneal dialysis for chronic renal failure. H. dematioides was repeatedly isolated from the dialysate culture specimens collected on days 3, 9, 16, and 20 of her hospital stay. Preliminary culture reports on day 7 of the growth of a yeast-like fungus, a probableCandida species, prompted the administration of fluconazole (FLU). Intraperitoneal and intravenous FLU failed to eliminate the mould, and the patient expired on day 21 of her hospital stay. We use this case to present what appears to be the first report of fungal peritonitis due to H. dematioides, to provide laboratorians with criteria for differentiating this organism from the similar mouldAureobasidium pullulans and from various yeast genera, and to provide a review of known fungal taxa inciting peritonitis.

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“…The drug was contin ued for 1 week after the dialysate leukocyte counts were normalized resulting approximately in a 5 week course of therapy. In 2 cases o f peritonitis caused by Torulopsis glabrata we measured 5-FC levels in serum and perito neal fluid [5]. In both cases the concentration o f 5-FC in the peritoneal effluent ranged between 50 and 80 pg/ml well above the minimum inhibitory concentration o f sus ceptible fungal strains.…”

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confidence: 99%