Peritonitis by Exophiala dermatitidis in a pediatric patient

Abstract

Fungal peritonitis is frequent on peritoneal dialysis, with rare cases by Exophiala dermatitidis . A 25-month-old female admitted to the pediatric ICU with acute renal failure was submitted to peritoneal dialysis. After 10 days patient presented fever. Peritoneal fluid culture showed yeast colonies molecularly identified as E. dermatitidis . Patient was treated with voriconazole and hemodialysis. The literature was reviewed. Disseminated infections are frequently fatal, but appropriate diagnose and therapeutic led to cure in this case.

The Neurotropic Black Yeast Exophiala dermatitidis Induces Neurocytotoxicity in Neuroblastoma Cells and Progressive Cell Death

“…Occasionally, it can cause mildly invasive systemic infections that are associated with significant morbidity and mortality. Typical infections are seen in immunocompromised hosts such as transplant recipients, oncology, and pediatric patients, where it manifests itself as a subcutaneous disease and rarely as deep mycoses [9,[22][23][24][25][26]. Particularly in East Asia, E. dermatitidis was detected in disseminated and neurotropic infections with high mortality [11,27].…”

Neurotropic black yeast Exophiala dermatitidis in children’s gut microbiota

“…3 A case of E. dermatitidis peritonitis was recently reported in a pediatric patient on peritoneal dialysis. 18 Patients N°2 and N°3 live together, as well as N°4 and N°5, this may support the proposed that water and maybe tropical fruits 8 (as pineapple and mango) can have a place in the transmission and it is possible that the transit through the gastrointestinal tract as E. dermatitidis may have thermo & acid tolerance and external mucopolysaccharides that allows avoid the phagocytosis. 4,8,11,19 Patient with DM1 diagnosis had a high CFU/mL (2x104) suggesting that may be related to the inherited innate immune disorders.…”

Peritoneal dialysis-associated peritonitis caused by Exophiala spinifera: A case report and review of literature

“… DM, HT, CAD ESI AMB Yes Survived Lau 2003 [ 14 ] 8 F 2 E. dermatitidis Culture, Seg. None No VRC Yes Survived Pinheiro 2019 [ 15 ] 9 F 52 E. spinifera Seq. DM, HT Cath.…”

“…Systemic fungal infections are rare in people with normal host immunity but can be observed in the lungs, lymph nodes, and central nervous system in immunocompromised hosts [ 4 , 7 ]. There are eight case reports of Exophiala peritonitis in the literature caused by E. dermatitidis, E. jeanselmei, or E. xenobiotica [ [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] ]. Here we provide the first report of peritoneal dialysis (PD)-associated peritonitis caused by E. spinifera , and review of the literature on Exophiala peritonitis in PD patients.…”