Timely diagnosis and management of -induced peritoneal dialysis peritonitis: A rare case highlighting the role of galactomannan testing.

Fungal peritonitis in peritoneal dialysis (PD) presents significant challenges. We report the second -related PD peritonitis in a 53-year-old male. Negative bacterial cultures and a positive galactomannan (GM) index in both PD effluent (PDE) (0.65) and serum (0.98) prompted early PD catheter removal on day 5. Molecular sequencing confirmed , with antifungal susceptibility testing revealing resistance to azoles and echinocandins but susceptibility to amphotericin B and isavuconazonium. Treatment with amphotericin B and voriconazole resolved symptoms, with no relapses during a two-year follow-up. This case highlights GM testing's critical role in guiding catheter removal and adherence to the 2022 ISPD Peritonitis Guidelines, ensuring favorable outcomes for rare fungal PD infections.