Visible penicillium spp. colonization plaques on a Tenckhoff catheter without resultant peritonitis in a peritoneal dialysis patient
Journal
Nephrology Dialysis Transplantation
Journal Volume
15
Journal Issue
11
Pages
1872-1873
Date Issued
2000
Author(s)
Abstract
Although advances in the design of exchange systems noted some greyish spots on the inner surface of minihave lowered the incidence of peritonitis, the disease transfer set. The spots increased in size, and the miniis still responsible for about 16% of deaths in PD transfer set was replaced with a new one. However, patients, especially those involving Gram-negative similar plaques developed on the new set 2 weeks later. bacilli and fungi [1], and an even higher percentage of At the same time, similar plaques were also noted on PD patients need catheter removal due to refractory the inner surface of the Tenckhoff catheter. The dialysperitonitis. Examination of these removed catheters ate effluent outflow was smooth and no abdominal revealed obvious micro-organism colonization, which symptoms were noted. The effluent was clear and may be the underlying cause of treatment failures due revealed no white cells or evidence of micro-organisms to its inherent antibiotic resistance [2]. However, on routine examination. Penicillium spp. were isolated whether a correlation exists between biofilm formation from the effluent cultures, and the Tenckhoff catheter and clinical peritonitis remains controversial [2]. was removed immediately; however, the culture of Although fungal peritonitis contribute to less than dialysate obtained by direct paracentesis did not reveal 10% of all episodes of peritonitis, these infections carry any pathogens. Microscopic examination of the a mortality rate of 17–25% [3]. In some cases, fungi removed Tenckhoff catheter showed entangled hyphae may colonize on the peritoneal catheter without caus- invading the catheter wall. The hyphae were intering peritonitis [4–6 ]. Herein we report the case of a mingled with the plaques of crystal deposition. chronic PD patient in whom Penicillium spp. hyphae The patient was placed on haemodialysis after cathhad colonized on the luminal surface of the mini- eter removal and did not receive any antifungal transfer set and Tenckhoff catheter. Although therapy. A new Tenckhoff catheter was implanted 1 Penicillium could be a pathogen of PD peritonitis year later, and the patient resumed peritoneal dialysis [7,8], as in a recent report [9], no evidence of peritonitis uneventfully. was found in the present case except for the visible grey plaques on the Tenckhoff catheter. This case provides confirmation that Penicillium colonization on the catheter alone might not result in peritonitis. Discussion
SDGs
Publisher
Oxford University Press
Type
journal article