Author/Editor		Bren, Andrej; Guček, Andrej; Lindič, Jelka; Kovač, Damjan; Kovač, Jani; Kandus, Aljoša
Title		Experiences with fungal peritonitis in patients on peritoneal dialysis (PD)
Type		članek
Source		In: Buturović-Ponikvar J, Bren AF, editors. Zbornik 2. slovenski nefrološki kongres z mednarodno udeležbo ob 30. letnici dialize in transplantacije ledvic v Sloveniji; 2000 sep 27-30; Brdo pri Kranju. Ljubljana: Klinični center, Klinični oddelek za nefrologijo,
Publication year		2000
Volume		str. 231-6
Language		eng
Abstract		The purpose of the study was to analyze the microbiological and clinical aspects of fungal peritonitis in patients with end stage renal failure treated with PD from 1983 through 1999. In this period we treated 19 cases of fungal peritonitis episodes. Diagnosis was based on abdominal discomfort or pain, cloudy peritoneal effluent with elevated number of leukocytes and on isolation of fungi from the peritoneal effluent. As antifungal treatment amphotericin B, flucytosine, ketoconazole, miconazole, and recently fluconazole were used. In 11 cases the clinical course of peritonitis was severe, and in eight cases, mild. Peritoneal effluent leukocyte count ranged from 115 to 5200 cells / NL. From the peritoneal effluent Candida albicans in three cases, Candida tropicalis was isolated in two cases, Candida parapsilosis in two cases, Candida lusitaniae in one case, Candida spp in one case, Candida glabra ta in one case, Cephalosporium spp. in three cases, Aspergillus fumigatus in two cases, and Aspergillus spp, Trichoderma spp, yeast, and Paecilomyces varioti in one case, each. In 11/19 (58%) previous recently bacterial infection treated with antibiotic, was detected. In 18/19 cases (95 %) a peritoneal catheter was removed. Five patients died during the treatment, and one patient died two months after the end of treatment due to intraabdominal bleeding from peritoneal adhesions. Only two patients (10 %) continued CAPD later, other patients were switched to hemodialysis. It was concluded that fungal peritonitis was serious complication with high degree of morbidity, mortality and associated with drop out from the CAPD program (90 %). The most frequent isolates were Candida spp. Predisposing factor for fungal peri tonitis could be a recent bacterial infection and antibiotic treatment. Early peritoneal catheter removal is recommended.
Descriptors		PERITONEAL DIALYSIS PERITONITIS CANDIDIASIS