Current concepts in the management of fungal peritonitis

Academic Article

Abstract

  • Fungal pathogens are uncommon isolates in the setting of peritonitis. Secondary peritonitis results from a breach in the gastrointestinal tract with gross contamination of the peritoneum. Peritonitis in patients undergoing peritoneal dialysis represents a unique form of secondary peritonitis often caused by nosocomial bacteria and fungi. Regardless of the clinical circumstances, most cases of fungal peritonitis are caused by Candida species, however other yeasts and filamentous fungi have been uncommonly reported. Treatment of secondary peritonitis consists of appropriate surgical intervention and systemic antifungal therapy. Systemic antifungals such as amphotericin B or fluconazole are also essential for the treatment of fungal peritonitis in patients who are peritoneal dialysis dependent Salvage of the peritoneal dialysis catheter may be attempted, however, removal is usually required to achieve cure. Prophylaxis with fluconazole in patients with recurrent gastraintestinal perforations or anastomotic leakages has reduced the incidence of Candidd peritonitis. Benefit of nystatin for fungal peritonitis prophylaxis in peritoneal dialysis patients is questionable. Copyright © 2003 by Current Science Inc.
  • Published In

    Digital Object Identifier (doi)

    Author List

  • Salvaggio MR; Pappas PG
  • Start Page

  • 120
  • End Page

  • 124
  • Volume

  • 5
  • Issue

  • 2