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J Med Microbiol 55 (2006), 115-118; DOI: 10.1099/jmm.0.46202-0
© 2006 Society for General Microbiology
ISSN 0022-2615

Case Report

Peritonitis due to Cunninghamella bertholletiae in a patient undergoing continuous ambulatory peritoneal dialysis

Jason D. Pimentel1, Gavin Dreyer2 and Gary D. Lum1

Northern Territory Government Pathology Service1 and Department of Renal Medicine2 , Royal Darwin Hospital, PO Box 41326, Casuarina, NT 0811, Australia

Correspondence
Jason D. Pimentel
pimentel{at}iprimus.com.au

Received 16 June 2005
Accepted 29 August 2005

Peritoneal dialysis-associated peritonitis due to fungi of the class Zygomycetes occurs very rarely. A case of fungal continuous ambulatory peritoneal dialysis peritonitis due to Cunninghamella bertholletiae is reported in a 39-year-old Aboriginal woman with end-stage renal failure and diabetes mellitus. This isolate was found to be resistant in vitro to amphotericin B, 5-fluorocytosine, fluconazole, itraconazole, ketoconazole and voriconazole. However, this patient was successfully treated with voriconazole and removal of the Tenckhoff dialysis catheter. Zygomycoses are an emerging threat among immunocompromised patients, including those with chronic renal failure. Zygomycosis due to C. bertholletiae is frequently fatal and is often non-responsive to systemic antifungal therapy. This is believed to be the first reported case of C. bertholletiae causing peritonitis in humans and one of the minority of cases involving this organism with a successful outcome.

Abbreviations: CAPD, continuous ambulatory peritoneal dialysis; FP, fungal peritonitis; IP, intra-peritoneal; PD, peritoneal dialysis.




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