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Query: UMLS:C0341503 (bacterial peritonitis)
 1,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-one episodes of fungal peritonitis occurred over 35 months among 290 patients on CAPD, accounting for 6.3% of all peritonitis episodes. Patients with more frequent bacterial peritonitis were at higher risk of developing fungal peritonitis, and 28.6% of cases followed antimicrobial therapy. Candida species accounted for 85.7% of cases. Oral fluconazole was used as initial therapy in all patients, which was followed by catheter removal if peritonitis failed to improve. The cure rate with fluconazole therapy alone without catheter removal was 9.5%. Fluconazole plus catheter removal, the latter necessitated in 85.7% of cases, resulted in a cure rate of 66.7%. The remaining 3 (14.3%) patients responded to intravenous amphotericin given as salvage therapy. Disease-related mortality was 14.3%. Reinsertion of dialysis catheter was attempted in 15 patients and CAPD was successfully resumed in 13 (86.7%). We conclude that oral fluconazole can be safely used as initial therapy in patients with fungal peritonitis complicating CAPD. Although catheter removal was necessary in the majority of patients, this sequential approach resulted in a relatively low prevalence of peritoneal adhesions and subsequent CAPD failure.
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PMID:Treatment of fungal peritonitis complicating continuous ambulatory peritoneal dialysis with oral fluconazole: a series of 21 patients. 772 19

Fungal peritonitis is a relatively uncommon complication of peritoneal dialysis that contributes significantly to morbidity, drop out from the continuous ambulatory peritoneal dialysis (CAPD) program, and mortality. Candida sake infections were rarely published in literature. We present the first case of peritonitis due to C. sake. A 41-year-old man was admitted to our hospital with abdominal pain, nausea, vomiting, fever, weakness. Abdominal ultrasonography demonstrated a fistula tract, which has an opening at inferolateral of the umbilicus extending 5 cm from the skin into the abdominal cavity with a foreign body (11 x 10 mm length) inside the fistula. The foreign body was removed by surgery being apparently a part of a previously inserted peritoneal catheter. Postoperative specimens revealed polymorph leucocytes and yeast cells in Gram stain, and culture on Sabouraud dextrose agar (SDA) yielded a growth of a fungus, subsequently identified as C. sake with Api ID 32C. Fluconazole (200 mg/day) therapy was started. He recovered after two weeks of therapy. In conclusion, C. sake, a rare type of Candida species, should be considered as a probable peritoneal pathogen in patients with multiple episodes of bacterial peritonitis, previous broad-spectrum antibiotic therapy and diabetes mellitus.
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PMID:First case of continuous ambulatory peritoneal dialysis peritonitis due to Candida sake. 1862 71

Peritonitis is one of the most serious complications of peritoneal dialysis. Pathogenic bacteria cause the majority of cases of peritonitis. Fungal infection is rare but it is associated with high morbidity, the inability to continue on the dialysis program and important mortality. Its incidence varies from 4% to 10% of all peritonitis episodes in children and from 1% to 23% in adults. Its clinical presentation is similar to bacterial peritonitis. Until now, predisposing factors of fungal peritonitis have not been clearly established; history of bacterial peritonitis episodes and treatment with broad-spectrum antibiotics have been often reported in the literature. Candida species were the most common pathogens and Candida albicans was the most frequent, but high prevalence of Candida parapsilosis has been observed in the last decade. Microbiological findings are essential to to determine the etiology of peritonitis. Successful management of fungal peritonitis requires antifungal therapy, the removal of peritoneal catheter and the subsequent transfer to hemodialysis. Fluconazole and amphotericin B are recommended as antifungal agents. New drugs as voriconazole and caspofungin are very effective. The aim of this systematic review has been to analyse the clinical and microbiological aspects of fungal peritonitis, as they are not well known and have changed in the last few years.
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PMID:[Clinical and microbiological aspects of fungal peritonitis in peritoneal dialysis]. 1993 94