FUSARIUM PERITONITIS IN A CHILD ON PERITONEAL-DIALYSIS - CASE-REPORT AND REVIEW OF THE LITERATURE

Objective: To review various aspects of the management of peritonitis due to Fusarium, a soil mold which infrequently causes infections in h umans. Data Sources: A case of Fusarium peritonitis in a child on chro nic peritoneal dialysis (PD) is presented. The child developed Fusariu m peritonitis 2 weeks after an episode of bacterial peritonitis. His T enckhoff catheter was removed, and he was maintained on hemodialysis w hile receiving intravenous amphotericin. Following 2 weeks of treatmen t with amphotericin, he was successfully returned to PD. A literature review of all previously reported cases of Fusarium peritonitis was th en conducted to determine features common to infections caused by Fusa rium. Emphasis was also placed on unique characteristics of the organi sm that may affect patient management, as well as patient characterist ics that may increase the risk for infection by Fusarium. Results: Fus arium may cause infection in immuno-suppressed individuals, such as ca ncer 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 Fu sarium may require catheter removal in addition to systemic antifungal therapy. Conclusions: This report presents the first known case of Fu sarium peritonitis in a child. In view of the difficulties posed by th is unusual organism, optimal therapy of Fusarium peritonitis should co nsist of immediate catheter removal and treatment with systemic antifu ngal drugs.