Accelerated recovery from Candida peritonitis of enteric origin by early surgical drainage in a peritoneal dialysis patient

Springer Science and Business Media LLC - Tập 15 Số 6 - Trang 957-961 - 2011
Kazama, Itsuro1,2, Muto, Shigeaki1, Inoue, Makoto1, Fukui, Taro1, Kotoda, Atsushi1, Takemura, Katsumi3, Kimura, Takaaki4, Ishikawa, Nobuo4, Yagisawa, Takashi4, Yumura, Wako1, Kusano, Eiji1
1Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan
2Department of Physiology I, Tohoku University Graduate School of Medicine, Sendai, Japan
3Takemura Nephrology Clinic, Kanuma, Japan
4Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University, Shimotsuke, Japan

Tóm tắt

A 62-year-old man on continuous ambulatory peritoneal dialysis was transferred to our hospital with recurrent abdominal pain and a cloudy peritoneal effluent. Three weeks before the transfer, his symptoms were successfully treated with broad-spectrum antibiotics. However, their effectiveness was lost for his recurrent symptoms. Fungal peritonitis was diagnosed because of an increased white blood cell count in the peritoneal fluid on admission and isolation of Candida albicans from a peritoneal fluid culture. Intravenous fos-fluconazole was immediately started, although it was ineffective for his deteriorating symptoms. The concomitant isolation of Candida albicans in a stool culture suggested that fungal peritonitis had an enteric origin. An emergency laparotomy revealed multiple diverticulosis and sigmoid colon diverticulitis. A surgical drainage was performed in addition to peritoneal catheter removal. Postoperatively, the patient’s symptoms improved rapidly and there were no signs of recurrence with continuous administration of fos-fluconazole. Surgical drainage accelerated the recovery from fungal peritonitis. This patient is the first case showing the usefulness of stool culture in the diagnosis of fungal peritonitis secondary to prior bacterial peritonitis. This case also demonstrated the importance of laparotomy to confirm the enteric origin of the fungus, and the efficacy of early surgical drainage for the treatment.

Tài liệu tham khảo

citation_journal_title=Perit Dial Int; citation_title=Infectious complications of peritoneal dialysis; citation_author=B Piraino; citation_volume=17; citation_issue=Suppl 3; citation_publication_date=1997; citation_pages=S15-S18; citation_id=CR1 citation_journal_title=J Infect; citation_title=Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis: a single centre Indian experience; citation_author=KN Prasad, N Prasad, A Gupta, RK Sharma, AK Verma, A Ayyagari; citation_volume=48; citation_publication_date=2004; citation_pages=96-101; citation_doi=10.1016/S0163-4453(03)00119-1; citation_id=CR2 citation_journal_title=Nephrol Dial Transplant; citation_title=Peritonitis due to Aspergillus niger in a patient on continuous ambulatory peritoneal dialysis shortly after kidney graft rejection; citation_author=E Bibashi, A Papagianni, A Kelesidis, R Antoniadou, M Papadimitriou; citation_volume=8; citation_publication_date=1993; citation_pages=185-187; citation_id=CR3 citation_journal_title=Nephron Clin Pract; citation_title=Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis: a single-centre experience in India; citation_author=R Ram, G Swarnalatha, P Neela, KV Murty; citation_volume=110; citation_publication_date=2008; citation_pages=c207-c212; citation_doi=10.1159/000167867; citation_id=CR4 citation_journal_title=Nephron; citation_title=Rectal stenosis associated with fungal peritonitis: a complication of continuous ambulatory peritoneal dialysis; citation_author=M Uchida, T Sakemi, Y Nagano, M Mizuguchi; citation_volume=53; citation_publication_date=1989; citation_pages=288-289; citation_doi=10.1159/000185765; citation_id=CR5 citation_journal_title=Crit Care Med; citation_title=Intra-abdominal Candida infection during acute necrotizing pancreatitis has a high prevalence and is associated with increased mortality; citation_author=A Hoerauf, S Hammer, B Muller-Myhsok, H Rupprecht; citation_volume=26; citation_publication_date=1998; citation_pages=2010-2015; citation_doi=10.1097/00003246-199812000-00031; citation_id=CR6 citation_journal_title=Am J Kidney Dis; citation_title=Factors predicting outcome of fungal peritonitis in peritoneal dialysis: analysis of a 9-year experience of fungal peritonitis in a single center; citation_author=AY Wang, AW Yu, PK Li, PK Lam, CB Leung, KN Lai; citation_volume=36; citation_publication_date=2000; citation_pages=1183-1192; citation_doi=10.1053/ajkd.2000.19833; citation_id=CR7 citation_journal_title=Adv Perit Dial; citation_title=Fungal peritonitis in peritoneal dialysis: critical review of six cases; citation_author=G Amici, S Grandesso, A Mottola, G Virga, G Calconi, C Bocci; citation_volume=10; citation_publication_date=1994; citation_pages=169-173; citation_id=CR8 citation_journal_title=Perit Dial Int; citation_title=Fungal peritonitis in peritoneal dialysis patients; citation_author=N Prasad, A Gupta; citation_volume=25; citation_publication_date=2005; citation_pages=207-222; citation_id=CR9 citation_journal_title=Perit Dial Int; citation_title=Peritoneal dialysis-related infections recommendations: 2010 update; citation_author=PK Li, CC Szeto, B Piraino, J Bernardini, AE Figueiredo, A Gupta; citation_volume=30; citation_publication_date=2010; citation_pages=393-423; citation_doi=10.3747/pdi.2010.00049; citation_id=CR10 citation_journal_title=Adv Perit Dial; citation_title=Endogenous peritonitis and related outcome in peritoneal dialysis patients; citation_author=H Suh, NK Wadhwa, T Cabralda, J Sorrento; citation_volume=12; citation_publication_date=1996; citation_pages=192-195; citation_id=CR11 citation_journal_title=Am J Kidney Dis; citation_title=Polymicrobial peritonitis in patients on continuous peritoneal dialysis; citation_author=JL Holley, J Bernardini, B Piraino; citation_volume=19; citation_publication_date=1992; citation_pages=162-166; citation_id=CR12 citation_journal_title=Rev Infect Dis; citation_title=Treatment of peritonitis due to Curvularia and Trichosporon with amphotericin B; citation_author=MR Ujhelyi, RH Raasch, CM Horst, WD Mattern; citation_volume=12; citation_publication_date=1990; citation_pages=621-627; citation_doi=10.1093/clinids/12.4.621; citation_id=CR13 citation_journal_title=Perit Dial Int; citation_title=Risk factors for developing peritonitis caused by micro-organisms of enteral origin in peritoneal dialysis patients; citation_author=F Caravaca, R Ruiz-Calero, C Dominguez; citation_volume=18; citation_publication_date=1998; citation_pages=41-45; citation_id=CR14 citation_journal_title=Am J Roentgenol; citation_title=Esophageal intramural pseudodiverticulosis: a reevaluation; citation_author=MS Levine, DN Moolten, H Herlinger, I Laufer; citation_volume=147; citation_publication_date=1986; citation_pages=1165-1170; citation_id=CR15 citation_journal_title=Arch Dermatol Res; citation_title=Effects of Candida albicans on wound-healing in an animal model (author’s transl); citation_author=M Dorn, R Russwurm; citation_volume=256; citation_publication_date=1976; citation_pages=205-212; citation_doi=10.1007/BF00567366; citation_id=CR16 citation_journal_title=Pediatr Nephrol; citation_title=Fungal peritonitis in children on peritoneal dialysis; citation_author=R Raaijmakers, C Schroder, L Monnens, E Cornelissen, A Warris; citation_volume=22; citation_publication_date=2007; citation_pages=288-293; citation_doi=10.1007/s00467-006-0289-x; citation_id=CR17 citation_journal_title=Kidney Int; citation_title=Fungal peritonitis in children receiving peritoneal dialysis: a report of the NAPRTCS; citation_author=BA Warady, M Bashir, LA Donaldson; citation_volume=58; citation_publication_date=2000; citation_pages=384-389; citation_doi=10.1046/j.1523-1755.2000.00176.x; citation_id=CR18 citation_journal_title=Perit Dial Int; citation_title=Update on fungal peritonitis and its treatment; citation_author=J Matuszkiewicz-Rowinska; citation_volume=29; citation_issue=Suppl 2; citation_publication_date=2009; citation_pages=S161-S165; citation_id=CR19 citation_journal_title=Nephrol Dial Transplant; citation_title=Treatment of fungal peritonitis complicating continuous ambulatory peritoneal dialysis with oral fluconazole: a series of 21 patients; citation_author=TM Chan, CY Chan, SW Cheng, WK Lo, CY Lo, IK Cheng; citation_volume=9; citation_publication_date=1994; citation_pages=539-542; citation_id=CR20 citation_journal_title=Int Urol Nephrol; citation_title=Fungal peritonitis in peritoneal dialysis: an analysis of 21 cases; citation_author=A Unal, I Kocyigit, MH Sipahioglu, B Tokgoz, O Oymak, C Utas; citation_volume=43; citation_issue=1; citation_publication_date=2011; citation_pages=211-213; citation_doi=10.1007/s11255-010-9763-2; citation_id=CR21 citation_journal_title=Nephrol Dial Transplant; citation_title=Treatment of peritoneal dialysis related fungal peritonitis with caspofungin plus amphotericin B combination therapy; citation_author=C Fourtounas, M Marangos, P Kalliakmani, E Savidaki, DS Goumenos, JG Vlachojannis; citation_volume=21; citation_publication_date=2006; citation_pages=236-237; citation_doi=10.1093/ndt/gfi162; citation_id=CR22
Thông tin
Thông tin xuất bản

Springer Science and Business Media LLC

Tập 15 Số 6

957-961

Thông tin tác giả