Peritonitis Due to Exophiala jeanselmei in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis

Agarwal, Sanjit; Goodman, Nelson; Malluche, Hartmut H.

doi:10.1016/s0272-6386(12)80043-6

Cited by 15 publications

(8 citation statements)

References 12 publications

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“…Peritonitis occurs essentially only in patients receiving peritoneal dialysis (6,8,69,97,106,115,117,144,197,261,302,305,367,405,416,461,466,563,598,605,618,619,656,690,762,765,783,784). The presentation is usually subacute, with many patients being without significant symptoms.…”

Section: Phaeohyphomycosismentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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SUMMARY Melanized or dematiaceous fungi are associated with a wide variety of infectious syndromes. Many are soil organisms and are generally distributed worldwide, though certain species appear to have restricted geographic ranges. Though they are uncommon causes of disease, melanized fungi have been increasingly recognized as important pathogens, with most reports occurring in the past 20 years. The spectrum of diseases with which they are associated has also broadened and includes allergic disease, superficial and deep local infections, pneumonia, brain abscess, and disseminated infection. For some infections in immunocompetent individuals, such as allergic fungal sinusitis and brain abscess, they are among the most common etiologic fungi. Melanin is a likely virulence factor for these fungi. Diagnosis relies on careful microscopic and pathological examination, as well as clinical assessment of the patient, as these fungi are often considered contaminants. Therapy varies depending upon the clinical syndrome. Local infection may be cured with excision alone, while systemic disease is often refractory to therapy. Triazoles such as voriconazole, posaconazole, and itraconazole have the most consistent in vitro activity. Further studies are needed to better understand the pathogenesis and optimal treatment of these uncommon infections.

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Section: Phaeohyphomycosismentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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“…The clinical spectrum of infection caused by these organisms include mycetomas, chromoblastomycosis, and pheohyphomycosis, either superficial, cutaneous, subcutaneous, or systemic (10,25). Deep-seated or systemic infections due to E. jeanselmei or Rhinocladiella are rare, with case reports of infection in the lungs (14,26), brain (9,30), peritoneum (1,12,22), and esophagus (6,27). In addition, there is a single case of possible hematogenous dissemination of E. jeanselmei in a patient who developed endocarditis and arthritis (24).…”

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confidence: 99%

Nosocomial Fungemia Due to Exophiala jeanselmei var. jeanselmei and a Rhinocladiella Species: Newly Described Causes of Bloodstream Infection

et al. 2001

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Fungi have become increasingly important causes of nosocomial bloodstream infections. The major cause of nosocomial fungemia has been Candida spp, but increasingly molds and other yeasts have caused disease. Exophiala jeanselmei and members of the genus Rhinocladiella are dematiaceous moulds, which have been infrequently associated with systemic infection and have not been described as causes of fungemia. In this paper, the occurrence of 23 cases of fungemia due to these organisms over a 10-month period is reported and the clinical characteristics of patients and outcomes are described. The majority of patients were immunosuppressed; 21 of 23 (91%) had received blood products and 78% had a central venous catheter. All patients had at least one manifestation of fever, but only one patient had signs or symptoms suggesting deep-seated infection. Antifungal therapy was given to 19 of the 23 patients; of those who did not receive therapy, 3 died prior to the culture result and 1 had been discharged without therapy. Antifungal susceptibility of the organisms showed activity of amphotericin B, itraconazole, and the new triazole antifungals voriconazole and posaconazole. E. jeanselmei and Rhinocladiella species are potential causes of nosocomial fungemia and may be associated with systemic infection.Systemic fungal infections are increasingly frequent in hospitalized patients (4). Whereas Candida species account for the majority of fungal infections, the spectrum of fungi that may cause infection is growing (2). Exophiala jeanselmei and Rhinocladiella species are dematiaceous fungi widely distributed in the environment, especially in soil, wood, polluted water, and sewage (7, 17). The clinical spectrum of infection caused by these organisms include mycetomas, chromoblastomycosis, and pheohyphomycosis, either superficial, cutaneous, subcutaneous, or systemic (10, 25). Deep-seated or systemic infections due to E. jeanselmei or Rhinocladiella are rare, with case reports of infection in the lungs (14, 26), brain (9, 30), peritoneum (1,12,22), and esophagus (6, 27). In addition, there is a single case of possible hematogenous dissemination of E. jeanselmei in a patient who developed endocarditis and arthritis (24). However, there have been no reports of fungemia due to these fungi. In this paper we report 23 cases of fungemia due to E. jeanselmei alone, E jeanselmei in combination with a Rhinocladiella species, or a Rhinocladiella species alone. MATERIALS AND METHODSThe University Hospital of the Universidade Federal do Rio de Janeiro is a tertiary-care hospital with 540 beds, including a 6-bed bone marrow transplant unit, a 20-bed intensive care unit, and a 6-bed semi-intensive postoperative unit. Laboratory records were reviewed to identify patients with positive blood cultures from December 1996 through October 1997. In December 1996, E. jeanselmei was isolated from blood cultures of two patients. During 1997, 21 other patients had positive blood cultures for either E. jeanselmei or a Rhinocladiella species.We reviewed th...

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“…Aureobasidium is frequently iso lated from soil, decaying vegetation and shower curtains. Dematiaceous fungi are causative organisms in a variety of fungal infections such as mycetoma, chromoblastomy cosis, and phaeohyphomycosis [8], and species other than Aureobasidium have been isolated from peritoneal dialy sate [9][10][11], Review of the literature reveals only a handful of clini cal reports of human infection caused by Aureobasidium species. Two cases of Aureobasidium-caused fungemia have been reported, one in a patient with acute leukemia following induction chemotherapy [12] and the other in a woman with advanced ovarian carcinoma and an indwell ing Broviac catheter [ 13], Also occurring in immunocom promised hosts, splenic abscesses due to Aureobasidium have been reported [14,15].…”

Section: Case Reportmentioning

confidence: 99%

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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Peritonitis Due to Exophiala jeanselmei in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis

Cited by 15 publications

References 12 publications

Melanized Fungi in Human Disease

Melanized Fungi in Human Disease

Nosocomial Fungemia Due to Exophiala jeanselmei var. jeanselmei and a Rhinocladiella Species: Newly Described Causes of Bloodstream Infection

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

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