Fungal Peritonitis Caused by Rhodotorula mucilaginosa in a CAPD Patient Treated with Liposomal Amphotericin B: A Case Report and Literature Review

Perit Dial Int. 2018 Jan-Feb;38(1):69-73. doi: 10.3747/pdi.2017.00096.

Abstract

Rhodotorula mucilaginosa is a ubiquitous yeast that may cause serious peritoneal dialysis (PD) infections. A 70-year-old man receiving continuous ambulatory peritoneal dialysis (CAPD) for 6 months presented with a PD infection caused by Rhodotorula mucilaginosa The patient was treated with intravenous liposomal amphotericin B. His peritoneal catheter was simultaneously removed and reinserted. To date, only 10 cases of Rhodotorula CAPD infections have been reported. Catheters, corticoids, cancer, and previous antibiotic therapy were the main risk factors for these infections. For most patients, the peritoneal catheter was removed, leading to a definitive transfer to hemodialysis. Along with flucytosine, amphotericin B is the main antifungal that is used. Both have a lower minimal inhibitory concentration (MIC), whereas fluconazole and caspofungin have the highest MICs. We highlighted the efficacy of liposomal amphotericin B associated with simultaneous withdrawal and reinsertion of a peritoneal catheter in a case of Rhodotorula peritonitis in a CAPD patient. Further studies are needed to evaluate the treatment of this condition.

Keywords: Rhodotorula mucilaginosa; continuous ambulatory peritoneal dialysis; yeast peritonitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Amphotericin B / therapeutic use*
  • Antifungal Agents / therapeutic use*
  • Humans
  • Male
  • Mycoses / diagnosis*
  • Mycoses / drug therapy
  • Peritoneal Dialysis, Continuous Ambulatory / adverse effects*
  • Peritonitis / drug therapy
  • Peritonitis / microbiology*
  • Rhodotorula / isolation & purification

Substances

  • Antifungal Agents
  • liposomal amphotericin B
  • Amphotericin B