First case of continuous ambulatory peritoneal dialysis peritonitis due to Candida sake

Mycoses. 2009 May;52(3):280-1. doi: 10.1111/j.1439-0507.2008.01562.x.

Abstract

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.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use
  • Candida / isolation & purification*
  • Candidiasis / drug therapy
  • Candidiasis / microbiology*
  • Fluconazole / therapeutic use
  • Humans
  • Male
  • Peritoneal Dialysis, Continuous Ambulatory / adverse effects*
  • Peritonitis / drug therapy
  • Peritonitis / microbiology*

Substances

  • Antifungal Agents
  • Fluconazole