CAPD peritonitis is one of the most important comlication of peritoneal dialysis. Among the CAPD peritonitis, fungal peritonitis is relatively rare but the prognosis is grave and removal of the peritoneal catheter is essential for management of
peritonitis. We report our center's experience of 21 episodes of fungal peritonitis confirmed by CAPD effluent culture from January, 1983 to March 1993.
The male to female ratio, the mean age, the mean duration of CAPD were 11:10, 48.2±11.2 years (range 17~70), 21.0±20.8 monthes91~72) respectively and the mean annual incidence of peritonitis was 1.47±1.49(0~4). The most common causitive fungi
were
candida species with 86%(N=18), and the remaining 3 cases were Trichosporon beigelii, Mucormycosis species, ryptococcus meoformans isolated respectively. The severe complications of fungal peritonitis were intraabdominal abscess combined with
intestinal
obstruction in 3 cases, sepsis in 2 cases, meningitis in 1 cases, and pneumonia in 1 case. patients were treated by cathter removal alone (N=50, by catheter removal followed by intravenous antifungal agent (N=13), or peritoneal catheter removal,
antifungal agent surgical drainage (N=3). Of these 60%, 92% and 100% were treated successfully respectively.
The complication and death rates were significantly low in the early peritoneal catheter removal group (within 7 days). And also, the group receiving antifungal agent more early showed better prognosis.
In conclusion, we recommednd early pe4ritoneal catheter removal, with antifungal emdications as soon as fungal peritonitis is diagnosed in CAPD patients. And if symptoms of intestinal obstruction or abdominal pain continue despite adequate
treatment,
complication such as intraabdominal abscess should be suspected.
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