Fusarium Peritonitis in a Child on Peritoneal Dialysis: Case Report and Review of the Literature

Author:

Flynn Joseph T.1,Meislich Debrah2,Kaiser Bruce A.1,Polinsky Martin S.1,Baluarte H. Jorge1

Affiliation:

1. Department of Pediatrics, Section of Nephrology, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, U.S.A.

2. Department of Pediatrics, Albert Einstein Medical Center, Philadelphia, Pennsylvania, U.S.A.

Abstract

ObjectiveTo review various aspects of the management of peritonitis due to Fusarium, a soil mold which infrequently causes infections in humans.Data SourcesA case of Fusarium peritonitis in a child on chronic peritoneal dialysis (PD) is presented. The child developed Fusarium peritonitis 2 weeks after an episode of bacterial peritonitis. His Tenckhoff catheter was removed, and he was maintained on hemodialysis while receiving intravenous amphotericin. Following 2 weeks of treatment with amphotericin, he was successfully returned to PD. A literature review of all previously reported cases of Fusarium peritonitis was then conducted to determine features common to infections caused by Fusarium. Emphasis was also placed on unique characteristics of the organism that may affect patient management, as well as patient characteristics that may increase the risk for infection by Fusarium.ResultsFusarium may cause infection inimmuno suppressed individuals, such as cancer patients or patients on chronic PD. The organism has a propensity to attach to foreign bodies such as intravascular and intraperitoneal catheters. Therefore, successful treatment of infections caused by Fusarium may require catheter removal in addition to systemic antifungal therapy.ConclusionsThis report presents the first known case of Fusarium peritonitis in a child. In view of the difficulties posed by this unusual organism, optimal therapy of Fusarium peritonitis should consist of immediate catheter removal and treatment with systemic antifungal drugs.

Publisher

SAGE Publications

Subject

Nephrology,General Medicine

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