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Successful Treatment by Voriconazole of Aspergillus niger Peritonitis in Automated Peritoneal Dialysis Patient

Barbera, Vincenzo MD; Mari, Raffaella PhD; Gorini, Antonio MD; Otranto, Giovanni MD; Di Lullo, Luca MD

Infectious Diseases in Clinical Practice: July 2014 - Volume 22 - Issue 4 - p e107–e109
doi: 10.1097/IPC.0000000000000167
Case Reports

Peritonitis represents the main and sometimes the most life-threatening complication in peritoneal dialysis (PD) patients. Fungal peritonitis account for 1% to 15% of all peritonitis in PD patients’ population with high mortality rate—up to 60%—and significant risk for PD dropout due to irreparable loss of peritoneal membrane properties after switch to hemodialysis. Etiological diagnosis is often delayed because of nonspecific clinical signs and symptoms compared to more common bacterial peritonitis and because of slow growth of mycotic spore in cultures.

In this article, we describe the case of a 71-year-old woman on PD who developed a fungal peritonitis caused by Aspergillus niger. The immediate Tenckhoff catheter removal and timely initiation of voriconazole treatment led to the patient’s complete recovery and return in PD. Voriconazole should be considered as a first-line therapy for PD peritonitis caused by A. niger.

From the Department of Nephrology and Dialysis, Colleferro County Hospital, Colleferro, Rome, Italy.

Correspondence to: Vincenzo Barbera, MD, Department of Nephrology and Dialysis, Colleferro County Hospital, Piazza Aldo Moro, 1, Colleferro, Rome Italy. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2014 by Lippincott Williams & Wilkins.