Fungal peritonitis caused by Bipolaris spicifera

• Published in: Medical mycology (Oxford) Vol. 41; no. 6; pp. 529 - 531
• Main Authors: Bava, A. J., Fayad, A., Céspedes, C., Sandoval, M.
• Format: Journal Article
• Language: English
• Published: UK Informa UK Ltd 01-12-2003; Taylor & Francis
• Subjects: Antifungal Agents - therapeutic use; Ascomycota - isolation & purification; Biological and medical sciences; Bipolaris spicifera; Catheterization; Child, Preschool; Female; Fluconazole - therapeutic use; Fundamental and applied biological sciences. Psychology; Humans; Infectious diseases; Medical sciences; Microbiology; Miscellaneous; Mycology; Mycoses; Mycoses - drug therapy; Peritoneal Dialysis, Continuous Ambulatory - adverse effects; Peritonitis - drug therapy; Peritonitis - microbiology; Pseudomonas; fungal peritonitis; Bipolaris spicifera; CAPD; dematiaceous fungi; Fungi; Microbiology; Abdominal disease; Fungi Imperfecti; Peritonitis; Thallophyta
• ISSN: 1369-3786; 1460-2709
• DOI: 10.1080/13693780310001610065

An episode of fungal peritonitis was produced by Bipolaris spicifera in a 3-year-old girl with chronic renal failure secondary to uremic-hemolytic syndrome and who was under treatment with continuous ambulatory peritoneal dialysis (CAPD). Previously, an episode of purulent peritonitis caused by Pseudomonas spp. had been treated successfully with combined antibacterial therapy for 10 days. Microscopic and macroscopic examinations of the freshly collected purulent dialysate were negative for fungal structures and bacteria. The fungus grew from the dialysate plated on Sabouraud dextrose agar and was also macroscopically recognized as a colony attached to the inner wall of the Tenckhoff catheter. Specific cultures of dialysate for common bacteria and mycobacteria were negative. The patient was successfully treated with early catheter removal and empirical administration of 200 mg/day oral fluconazole for 2 weeks. Subsequently, a new catheter was placed and the patient continued well on CAPD. Post-treatment control cultures of dialysate for fungi, bacteria and mycobacteria were negative and the cell count returned to normal.