Am. Yinnon et al., CRYPTOCOCCAL PERITONITIS - REPORT OF A CASE DEVELOPING DURING CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS AND REVIEW OF THE LITERATURE, Clinical infectious diseases, 17(4), 1993, pp. 736-741
A patient developed cryptococcal peritonitis with systemic disseminati
on during continuous ambulatory peritoneal dialysis (CAPD). This case
prompted a search of the literature for cases of cryptococcal peritoni
tis; 19 previously reported cases were identified. On the basis of the
ir clinical characteristics, these cases were divided into two groups.
Group 1 included 10 cases developing during CAPD. Treatment consisted
of removal of the peritoneal dialysis catheter and administration of
a short course of amphotericin B. Eight of the 10 cases had a benign c
ourse, and nine patients survived. Group 2 comprised 10 cases developi
ng in patients with severe underlying illnesses, such as chronic liver
disease, AIDS, systemic lupus erythematosus, and leukemia. Disseminat
ed cryptococcosis was documented in eight of the nine patients in this
group for whom relevant information was available. Seven patients die
d, some despite antifungal therapy. Cryptococcal disease may have prot
ean manifestations and an insidious course. Accordingly, the diagnosis
of cryptococcal peritonitis may well be delayed. An awareness of this
entity may lead to earlier diagnosis and treatment and possibly to im
proved outcome.