PAECILOMYCES VARIOTI PERITONITIS IN PATIENTS ON CONTINUOUS AMBULATORYPERITONEAL-DIALYSIS

Paecilomyces varioti infection is a rare cause of peritonitis in patie nts on continuous ambulatory peritoneal dialysis (CAPD). We report two patients who developed P varioti peritonitis complicating CAPD, The c linical features and microbiological data of seven other previously re ported cases are reviewed, Approximately half of the patients had rece ived multiple antibiotics before the onset of the peritonitis because of either bacterial peritonitis or exit site infection, There was no p articular pattern of peritoneal dialysate cell count, which was charac teristic in this fungal peritonitis, Although all patients survived, m orbidity was high, All patients required antifungal chemotherapy and r emoval of peritoneal catheter for eradication of the organism, Amphote ricin B was effective in most cases, Patients of all previously report ed cases did not go back to peritoneal dialysis after removal of perit oneal catheters, A combination of oral flucytosine and itraconazole wa s successful in treating our two patients, Although we managed to resu me CAPD in our two patients with good functional outcome, abscesses an d adhesions were major problems rendering most patients from other ser ies failing to return to CAPD after recovery. (C) 1996 by the National Kidney Foundation, Inc.