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Fungal Peritoneal Dialysis-Associated Peritonitis as a Silent Threat: The Critical Role of Early Diagnosis and Catheter Removal

Year: 2024

Type: article

Abstract: Fungal peritonitis is an uncommon but serious complication that can occur in patients undergoing peritoneal dialysis. It represents a small percentage of all peritonitis cases in these patients. Its diagnosis can be challenging due to the slow growth of fungi and frequent negative culture results. We report a case of fungal peritonitis in a 71-year-old man on automated peritoneal dialysis (APD). The patient presented with relapsing peritonitis unresponsive to antibiotics. During catheter removal, fungal hyphae were identified, confirming fungal peritonitis despite negative cultures. Prompt catheter removal and antifungal therapy with fluconazole led to infection resolution. The patient transitioned to hemodialysis. This case highlights the importance of early suspicion and intervention in fungal peritonitis. Prolonged antibiotics and recurrent infections should raise concern for fungal etiology, particularly in refractory cases. Early catheter removal, combined with targeted antifungal therapy, is critical to successful outcomes. Our findings emphasize the diagnostic challenges of fungal peritonitis and the need for advanced microbiological techniques and collaborative care between clinicians and microbiologists.

Source: Cureus

DOI: 10.7759/cureus.76191

Authors: Mariana Freitas, Viviane Calice Silva

Institution: Unidade Local de Saúde de Trás-os-Montes e Alto Douro

Language: English

Topic: Dialysis and Renal Disease Management

Subfield: Nephrology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4405679292