Treatment of dialysis-related fungal peritonitis in children — case report and literature review

Abstract

Dialysis-related peritonitis is one of the infectious complications of peritoneal dialysis. The etiology of that complication in majority of patients is bacterial, but in 3–6% of cases pathogenic fungi are identified as the etiological agent. Fungal peritonitis is usually characterized by severe clinical course, often resistant to applied pharmacotherapy and is burdened with high mortality (15–50%). We present a case of fungal peritonitis diagnosed in a 10-year-old boy treated with long-term automated peritoneal dialysis. Despite the identification of the etiological agent (yeast fungus Candida parapsilosis) and the use of combined antifungal targeted therapy) the course of the disease was unfavorable, leading to patient’s death. The principles of diagnosis, prevention and treatment of fungal peritonitis with the emphasis on currently available possibilities of targeted pharmacotherapy have been discussed.