Chamroensakchai Tamonwan, Sanaklang Nipaporn, Hurdeal Vedprakash G, Banjongjit Athiphat, Hyde Kevin D, Kanjanabuch Talerngsak
Center of Excellence in Kidney Metabolic Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
Fort Suranari Hospital, Nakhon Ratchasima, 30000, Thailand.
Med Mycol Case Rep. 2022 Dec 5;39:5-7. doi: 10.1016/j.mmcr.2022.11.002. eCollection 2023 Mar.
Fungal peritonitis (FP) is usually associated with poor patient outcomes and is mostly caused by non- species. We present a -associated peritonitis in a 68-year-old woman with end-stage kidney disease on peritoneal dialysis (PD). Biochemical profiling of the cultured yeast of the effluent sample did not adequately identify the yeast. Hence, molecular phylogeny and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight (MALDI-TOF) mass spectroscopy were employed which correctly identified the causative species, . PD catheter was removed and oral fluconazole was promptly started according to the 2022 International Society for PD (ISPD) Peritonitis Guidelines. However, the patient achieved only a partial clinical response and eventually died. The susceptibility test showed that the pathogen was susceptible to amphotericin B and voriconazole but resistant to other triazoles. This report underlines the importance of identifying the species, though rarely reported, and the drug susceptibility of the organism.
真菌性腹膜炎（FP）通常与患者预后不良相关，且大多由非 种引起。我们报告了一名68岁终末期肾病行腹膜透析（PD）的女性发生的 相关性腹膜炎。对流出液样本中培养的酵母进行生化分析未能充分鉴定出该酵母。因此，采用了分子系统发育分析和基质辅助激光解吸/电离飞行时间（MALDI-TOF）质谱分析，从而正确鉴定出致病菌种 。根据2022年国际腹膜透析学会（ISPD）腹膜炎指南，拔除了PD导管并立即开始口服氟康唑治疗。然而，患者仅获得部分临床缓解，最终死亡。药敏试验表明，该病原体对两性霉素B和伏立康唑敏感，但对其他三唑类耐药。本报告强调了鉴定该菌种（虽报道较少）及其药敏情况的重要性。
