Fungal peritonitis in children on peritoneal dialysis

Enriquez, Jose Luis; Kalia, Alok; Travis, Luther B.

doi:10.1016/s0022-3476(05)83353-0

Cited by 8 publications

(13 citation statements)

References 15 publications

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“…Generally the mortality rate for FP in children seems to be lower than in adults, 0-6% [5,18] versus 13-53% [2,4,10,11,17]. Technique failure on the other hand is high in both adults and children, around 50%, in literature [5,14,17,18] as well as in our study. In our opinion this might justify early, but not immediate, removal of the catheter in children, after peritoneal lavage with antimycotics has been ensured to minimise peritoneal damage.…”

Section: Discussionsupporting

confidence: 60%

“…In children, no relationship has been established between the time of catheter removal and mortality rate or technique failure [5]. Generally the mortality rate for FP in children seems to be lower than in adults, 0-6% [5,18] versus 13-53% [2,4,10,11,17]. Technique failure on the other hand is high in both adults and children, around 50%, in literature [5,14,17,18] as well as in our study.…”

Section: Discussioncontrasting

confidence: 49%

“…Candida spp. are the most frequently encountered causative organisms in FP, accounting for 68-89% of adult cases [2,4,10,11,17] and 79-100% of paediatric cases [5,18]. C. albicans is still the predominating organism but in the more recent studies non-albicans Candida spp.…”

Section: Discussionmentioning

confidence: 99%

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Fungal peritonitis in children on peritoneal dialysis

et al. 2007

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Fungal peritonitis is a rare but serious complication in children on peritoneal dialysis (PD). In this study, risk factors were evaluated, and therapeutic measures were reviewed. A retrospective, multi-centre study was performed in 159 Dutch paediatric PD patients, between 1980 and 2005 (3,573 months). All peritonitis episodes were reviewed. Fungal peritonitis episodes were evaluated based on possible risk factors and treatment strategy. A total of 321 episodes of peritonitis occurred, with 9 cases of fungal peritonitis (2.9%). Candida peritonitis occurred most frequently (78%). Seven patients (78%) had used antibiotics in the prior month. Fungal peritonitis patients had a higher previous bacterial peritonitis rate compared to the total study population (0.13 versus 0.09 episodes/patient*month), with twice as many gram negative organisms. In all fungal peritonitis patients, the PD catheter was removed. In four patients restart on PD was possible. Fungal peritonitis is a rare complication of PD in children, but is associated with high technique failure. The most important risk factors are a high bacterial peritonitis rate, prior use of antibiotics, and previous bacterial peritonitis with gram negative organisms. The PD catheter should be removed early, but in children, peritoneal lavage with fluconazole before removal may be useful to prevent technique failure.

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Section: Discussionsupporting

confidence: 60%

Section: Discussioncontrasting

confidence: 49%

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Fungal peritonitis in children on peritoneal dialysis

et al. 2007

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“…Although most cases are of bacterial origin, cases of fungal peritonitis comprise 2-15% of episodes, with Candida sp. being the most common isolate [1][2][3][4]. In this report, we describe a child receiving continuous cycling peritoneal dialysis (CCPD) with peritonitis and catheter obstruction caused by Curvularia species.…”

Section: Introductionmentioning

confidence: 99%

Fungal peritonitis caused by Curvularia species in a child undergoing peritoneal dialysis

Canon

Buckingham

Wyatt

et al. 2001

Pediatric Nephrology

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We report the first case of peritonitis caused by Curvularia species in a child undergoing peritoneal dialysis. He presented with gray-black proteinaceous material obstructing the lumen of his Tenckhoff catheter. Although the peritoneal fluid was cloudy, the patient suffered neither significant abdominal tenderness nor systemic symptoms. Catheter removal and treatment with amphotericin B allowed complete recovery and return to peritoneal dialysis within 7 days. Outdoor play in a wooded environment may have allowed contact of this saprophytic fungus with the child's indwelling catheter transfer set.

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“…Other investigators have reported the incidence of fungal peritonitis to vary from 5 to 15% of CAPD-associated peritonitis [2][3][4][5]. While a variety of fungal species have been isolated from peritoneal dialysate, Candida species are the predominant organisms [1][2][3][4][5][6][7], To our knowledge, the patient presented here is the first report of a CAPD-associated peritonitis due to an Aureobasidium species. The isolation of this organism from two separate specimens and his response to catheter removal and antifungal therapy indicate that Aureobasid ium was the cause of peritonitis in our patient and not a contaminant.…”

mentioning

confidence: 82%

Continuous Ambulatory Peritoneal Dialysis Complicated by <i>Aureobasidium pullulans </i>Peritonitis

Clark

Silver²,

Hollick³

et al. 1995

Am J Nephrol

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We describe a case of peritonitis caused by Aureobasidium pullulans in a patient on continuous ambulatory peritoneal dialysis (CAPD). This dematiaceous fungus rarely causes infection in humans and to date has not been reported as an etiology of CAPD-associated peritonitis. The patient was managed successfully with peritoneal catheter removal and a prolonged course of intravenous amphotericin B, allowing resumption of CAPD. In vitro susceptibility testing confirmed sensitivity of this organism to amphotericin B.

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Fungal peritonitis in children on peritoneal dialysis

Cited by 8 publications

References 15 publications

Fungal peritonitis in children on peritoneal dialysis

Fungal peritonitis in children on peritoneal dialysis

Fungal peritonitis caused by Curvularia species in a child undergoing peritoneal dialysis

Continuous Ambulatory Peritoneal Dialysis Complicated by <i>Aureobasidium pullulans </i>Peritonitis

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