Fungal peritonitis in pediatric patients.

B. S. Montane, I. Mazza, Carolyn Abitbol, Gaston E Zilleruelo, J. Strauss, S. Coakley, R. Diaz

Research output: Contribution to journalArticle

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Abstract

Fungal peritonitis (FP) is a rare complication of peritoneal dialysis (PD). Although treatment with fluconazole (FCZ) has improved catheter survival and preservation of the peritoneal membrane, FP still carries a high morbidity and mortality in pediatrics. High-risk factors for FP include previous usage of systemic antibiotics and recurrent bacterial peritonitis. A prospective experience in the treatment of FP was conducted at the University of Miami/Jackson Children's Hospital from 1992 to 1997. All patients received either oral or intravenous loading dose of FCZ (5-7 mg/kg) followed by intraperitoneal (i.p.) FCZ (75 mg/L). Amphotericin B (amp B) was added when clinical sepsis was present. A total of 6 patients had FP (all Candida sp.; mean age: 6 years). Two of these patients were neonates with Tenckhoff-catheter placement at less than 1 week of age. Five patients achieved sterilization of the peritoneal fluid. One patient required catheter removal (C. tropicalis). The 2 neonates were infection free for 29 and 41 days, respectively, but both died of superimposed bacterial sepsis. The remaining 4 patients survived and completed 6 weeks of FCZ treatment. Two have had preservation of the peritoneal membrane for more than 1 year. The other 2 were switched to hemodialysis. We conclude that FCZ is an effective treatment for fungal peritonitis in pediatric patients. Adjunct therapy with amp B is usually necessary if sepsis is present. Although eradication of the fungus is possible in a majority of cases, neonates and immunocompromised hosts remain at high risk for morbidity and mortality.

Original languageEnglish
Pages (from-to)251-254
Number of pages4
JournalAdvances in peritoneal dialysis. Conference on Peritoneal Dialysis
Volume14
StatePublished - Jan 1 1998

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Peritonitis
Fluconazole
Pediatrics
Sepsis
Catheters
Newborn Infant
Amphotericin B
Morbidity
Therapeutics
Membranes
Mortality
Ascitic Fluid
Immunocompromised Host
Peritoneal Dialysis
Candida
Renal Dialysis
Fungi
Anti-Bacterial Agents
Infection

Cite this

Montane, B. S., Mazza, I., Abitbol, C., Zilleruelo, G. E., Strauss, J., Coakley, S., & Diaz, R. (1998). Fungal peritonitis in pediatric patients. Advances in peritoneal dialysis. Conference on Peritoneal Dialysis, 14, 251-254.

Fungal peritonitis in pediatric patients. / Montane, B. S.; Mazza, I.; Abitbol, Carolyn; Zilleruelo, Gaston E; Strauss, J.; Coakley, S.; Diaz, R.

In: Advances in peritoneal dialysis. Conference on Peritoneal Dialysis, Vol. 14, 01.01.1998, p. 251-254.

Research output: Contribution to journalArticle

Montane, BS, Mazza, I, Abitbol, C, Zilleruelo, GE, Strauss, J, Coakley, S & Diaz, R 1998, 'Fungal peritonitis in pediatric patients.', Advances in peritoneal dialysis. Conference on Peritoneal Dialysis, vol. 14, pp. 251-254.
Montane BS, Mazza I, Abitbol C, Zilleruelo GE, Strauss J, Coakley S et al. Fungal peritonitis in pediatric patients. Advances in peritoneal dialysis. Conference on Peritoneal Dialysis. 1998 Jan 1;14:251-254.
Montane, B. S. ; Mazza, I. ; Abitbol, Carolyn ; Zilleruelo, Gaston E ; Strauss, J. ; Coakley, S. ; Diaz, R. / Fungal peritonitis in pediatric patients. In: Advances in peritoneal dialysis. Conference on Peritoneal Dialysis. 1998 ; Vol. 14. pp. 251-254.
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