Candida guilliermondii Peritonitis During Peritoneal Dialysis. Case Report and Literature Review
DOI: https://doi.org/10.7175/cmi.v17i1.1537
Abstract
Peritonitis is the most frequent complication of peritoneal dialysis (PD) and 3–6% of episodes have fungal origin. Candida guilliermondii is an uncommon species of Candida with invasive behavior in patients affected by severe underlying disorders or using indwelling vascular devices.
Here we report the case of an 84-year-old woman undergoing outpatient PD for 4 years who had fever, chills, and diffuse increasing abdominal pain. After empiric antimicrobial therapy, based on teicoplanin in the dialytic circuit plus oral ciprofloxacin plus fluconazole, the patient was hospitalized. Afterwards, the culture from the peritoneal fluid showed the presence of C. guilliermondii.
PD-related fungal peritonitis is an infrequent event, but the morbidity and mortality rates are significant. In this scenario, appropriate prevention strategies including antifungal prophylaxis during antibiotic treated bacterial peritonitis should be evaluated.
Keywords
Candida guilliermondii; Nephrology; Peritoneal Dialysis; Peritonitis
References
- Castellani A. Observations on the fungi found in tropical bronchomycosis. Lancet 1912; 179: 13-15; https://doi.org/10.1016/S0140-6736(00)51698-5
- Akpolat T. Tuberculous peritonitis. Perit Dial Int 2009; 29 Suppl 2: S166-S169
- Marcos-Zambrano LJ, Puig-Asensio M, Pérez-García F, et al; CANDIPOP study. Candida guilliermondii complex is characterized by high antifungal resistance but low mortality in 22 cases of candidemia. Antimicrob Agents Chemother 2017; 61: e00099-17; https://doi.org/10.1128/AAC.00099-17
- Manfredi R. Expansion of a recent class of broad-spectrum antifungal agents: the echinocandins. Microbiologia Medica 2009; 24: 9-21; https://doi.org/10.4081/mm.2009.2522
- Giacobino J, Montelli AC, Barretti P, et al. Fungal peritonitis in patients undergoing peritoneal dialysis (PD) in Brazil: molecular identification, biofilm production and antifungal susceptibility of the agents. Med Mycol 2016; 54: 725-32; https://doi.org/10.1093/mmy/myw030
- Miles R, Hawley CM, McDonald SP, et al. Predictors and outcomes of fungal peritonitis in peritoneal dialysis patients. Kidney Int 2009; 76: 622-8; https://doi.org/10.1038/ki.2009.202
- Harvey DM, Sheppard KJ, Morgan AG, et al. Effect of dialysate fluids on phagocytosis and killing by normal neutrophils. J Clin Microbiol 1987; 25: 1424-7; https://doi.org/10.1111/j.1365-2141.1988.tb04202.x
- Harvey DM, Sheppard KJ, Morgan AG, et al. Neutrophil function in patients on continuous ambulatory peritoneal dialysis. Br J Haematol 1988; 68: 273-8; https://doi.org/10.1111/j.1365-2141.1988.tb04202.x
- Daniels I, Lindsay M, Porter C, et al. Effect of peritoneal dialysis effluent on superoxide anion production by polymorphonuclear neutrophils. Nephron 1993; 64: 382-7; https://doi.org/10.1159/000187358
- Miles R, Hawley C, McDonald SP, et al. Predictors and outcomes of fungal peritonitis in peritoneal dialysis patients. Kidney Int 2009; 76: 622-8; https://doi.org/10.1038/ki.2009.202
- Kim M, Bae EH, Kim SW, et al. Candida guilliermondii continuous ambulatory peritoneal dialysis peritonitis confirmed by 16s rRNA sequencing. Nephrology (Carlton) 2016; 21: 630; https://doi.org/10.1111/nep.12650. PMID: 27334354
- Li PK, Chow KM, Cho Y, et al. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Perit Dial Int 2022; 42: 110-53; https://doi.org/10.1177/08968608221080586
- Zuo XS, Liu Y, Cai X, et al. Association of different Candida species with catheter-related candidemia, and the potential antifungal treatments against their adhesion properties and biofilm-forming capabilities. J Clin Lab Anal 2021; 35: e23738; https://doi.org/10.1002/jcla.23738
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