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KMID : 0359919960150020221
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Korean Journal of Nephrology
1996 Volume.15 No. 2 p.221 ~ p.225
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Peritonitis due to Aspergillus terreus in a CAPD Patient
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Abstract
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Aspergillus peritonitis is rare in CAPD patients and is associated with high mortality. We report a case of CAPD peritonitis due to A. terreus successfully treated with a combintion of fluconazole therapy and peritoneal catheter removal.
The patient, a 53 year-old on CAPD for 5 months, had sudden onset of diffuse abdominal pain and cloudy effluent. He was initially treated with intraperitoneal cefuroxime and netilmicin. Four days later, there was no improvement of his symptoms,
and
the
patients was admitted to the hospital. On the surface of the inner lumen of the peritoneal catheter, numerous small visible colonies were found. Dialysate samples showed evidence of positive fungal mycelia and spores in the KOH mount. The
catheter
was
removed immediately, and fluconazole was intravenously betun and ocntinued orally for 3 weeks. All amples of dialysate and catheter tip grew A. terreus. Peritonitis symptoms and signs were improved gradually after peritoneal catheter removal and
fluconazole therapy. Early peritoneal catheter removal and antifungal therapy may be most important in treatment of dialysis-related Aspergillus peritonitis. The possibility of a pathogenic A. terreus infection should be considered in CAPD
peritonitis
patients.
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