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Fungal Peritonitis Caused by Rhodotorula mucilaginosa in a CAPD Patient Treated with Liposomal Amphotericin B: A Case Report and Literature Review

Journal

PERITONEAL DIALYSIS INTERNATIONAL
Volume 38, Issue 1, Pages 69-+

Publisher

SAGE PUBLICATIONS INC
DOI: 10.3747/pdi.2017.00096

Keywords

Rhodotorula mucilaginosa; continuous ambulatory peritoneal dialysis; yeast peritonitis

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Rhodotorula mucilaginosa is a ubiquitous yeast that may cause serious peritoneal dialysis (PD) infections. A 70-year-old man receiving continuous ambulatory peritoneal dialysis (CAPD) for 6 months presented with a PD infection caused by Rhodotorula mucilaginosa. The patient was treated with intravenous liposomal amphotericin B. His peritoneal catheter was simultaneously removed and reinserted. To date, only 10 cases of Rhodotorula CAPD infections have been reported. Catheters, corticoids, cancer, and previous antibiotic therapy were the main risk factors for these infections. For most patients, the peritoneal catheter was removed, leading to a definitive transfer to hemodialysis. Along with flucytosine, amphotericin B is the main antifungal that is used. Both have a lower minimal inhibitory concentration (MIC), whereas fluconazole and caspofungin have the highest MICs. We highlighted the efficacy of liposomal amphotericin B associated with simultaneous withdrawal and reinsertion of a peritoneal catheter in a case of Rhodotorula peritonitis in a CAPD patient. Further studies are needed to evaluate the treatment of this condition.

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