Along came a spider : an unusual organism identified in a peritoneal dialysis patient, a case report and literature review

BACKGROUND: Peritoneal dialysis-associated peritonitis can uncommonly be caused by fungal infections. When they do present, they are associated with significant mortality and morbidity. We describe a case where a sample of peritoneal dialysate fluid grew Rhodotorula muciliginosa, a yeast organism present in the normal environment which has previously been reported as rarely causing peritonitis. We believe this is the first case where the Rhodotorula spp. and its origin has been identified.

CASE PRESENTATION: A 20 year old male grew Rhodotorula muciliginosa from his peritoneal dialysis fluid on three separate occasions when a fluid sample was sent following a disconnection and subsequent set change. He was not systemically unwell and his peritoneal dialysate was clear. As Rhodotorula spp. is exceedingly difficult to treat our patient had his Tenchkoff catheter removed. Subsequent samples of soil and sand from his bearded dragon and Chilean tarantula cases, kept in his bedroom where dialysis occurred, were tested. The tarantula sand was identified as the source of the Rhodotorula spp. Of note, Candida was isolated from sand from the bearded dragon case. Once his Tenchkoff was removed he was treated with an intravenous course of antifungal therapy. He has since had a new Tenchkoff catheter inserted and recommenced PD following education around pets and hygiene.

CONCLUSIONS: In this era where people are keeping increasingly rare and unusual wildlife in their homes, this case highlights the need for clinician and nursing staff awareness of a patient's home environment and hobbies when they are undergoing peritoneal dialysis. Sand from our patient's tarantula case grew the colonising organism but interestingly soil from his bearded dragon case also isolated candida. This can also cause difficult to treat peritonitis.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:21

Enthalten in:

BMC nephrology - 21(2020), 1 vom: 11. Nov., Seite 474

Sprache:

Englisch

Beteiligte Personen:

Carnall, Victoria Jane [VerfasserIn]
Murdock, Stephanie [VerfasserIn]
Auckland, Cressida [VerfasserIn]
Mulgrew, Christopher J [VerfasserIn]

Links:

Volltext

Themen:

7XU7A7DROE
Amphotericin B
Antifungal Agents
Case Reports
Case report
Fungal infection
Journal Article
Peritonitis
Pets
Rhodotorula
Zoonotic

Anmerkungen:

Date Completed 01.11.2021

Date Revised 01.11.2021

published: Electronic

Citation Status MEDLINE

doi:

10.1186/s12882-020-02099-8

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM317443372