Flynn J T, Meislich D, Kaiser B A, Polinsky M S, Baluarte H J
Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, USA.
Perit Dial Int. 1996 Jan-Feb;16(1):52-7.
To review various aspects of the management of peritonitis due to Fusarium, a soil mold which infrequently causes infections in humans.
A case of Fusarium peritonitis in a child on chronic peritoneal dialysis (PD) is presented. The child developed Fusarium peritonitis 2 weeks after an episode of bacterial peritonitis. His Tenckhoff catheter was removed, and he was maintained on hemodialysis while receiving intravenous amphotericin. Following 2 weeks of treatment with amphotericin, he was successfully returned to PD. A literature review of all previously reported cases of Fusarium peritonitis was then conducted to determine features common to infections caused by Fusarium. Emphasis was also placed on unique characteristics of the organism that may affect patient management, as well as patient characteristics that may increase the risk for infection by Fusarium.
Fusarium may cause infection in immunosuppressed individuals, such as cancer patients or patients on chronic PD. The organism has a propensity to attach to foreign bodies such as intravascular and intraperitoneal catheters. Therefore, successful treatment of infections caused by Fusarium may require catheter removal in addition to systemic antifungal therapy.
This report presents the first known case of Fusarium peritonitis in a child. In view of the difficulties posed by this unusual organism, optimal therapy of Fusarium peritonitis should consist of immediate catheter removal and treatment with systemic antifungal drugs.
回顾由镰刀菌引起的腹膜炎的管理的各个方面，镰刀菌是一种很少引起人类感染的土壤霉菌。
本文报道了一例慢性腹膜透析（PD）患儿发生的镰刀菌腹膜炎。该患儿在一次细菌性腹膜炎发作2周后发生了镰刀菌腹膜炎。他的Tenckhoff导管被拔除，在接受静脉两性霉素治疗的同时维持血液透析。两性霉素治疗2周后，他成功恢复了腹膜透析。随后对所有先前报道的镰刀菌腹膜炎病例进行了文献综述，以确定镰刀菌感染的常见特征。还重点关注了可能影响患者管理的该生物体的独特特性，以及可能增加镰刀菌感染风险的患者特征。
镰刀菌可能在免疫抑制个体中引起感染，如癌症患者或慢性腹膜透析患者。该生物体倾向于附着在诸如血管内和腹膜内导管等异物上。因此，成功治疗镰刀菌引起的感染可能除了全身抗真菌治疗外还需要拔除导管。
本报告介绍了首例已知的儿童镰刀菌腹膜炎病例。鉴于这种不寻常的生物体带来的困难，镰刀菌腹膜炎的最佳治疗应包括立即拔除导管和使用全身抗真菌药物治疗。
