caa a22 4500 445882883 CHVBK 20180317145550.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s10157-011-0507-0 doi (NATIONALLICENCE)springer-10.1007/s10157-011-0507-0 Accelerated recovery from Candida peritonitis of enteric origin by early surgical drainage in a peritoneal dialysis patient [Elektronische Daten] [Itsuro Kazama, Shigeaki Muto, Makoto Inoue, Taro Fukui, Atsushi Kotoda, Katsumi Takemura, Takaaki Kimura, Nobuo Ishikawa, Takashi Yagisawa, Wako Yumura, Eiji Kusano] A 62-year-old man on continuous ambulatory peritoneal dialysis was transferred to our hospital with recurrent abdominal pain and a cloudy peritoneal effluent. Three weeks before the transfer, his symptoms were successfully treated with broad-spectrum antibiotics. However, their effectiveness was lost for his recurrent symptoms. Fungal peritonitis was diagnosed because of an increased white blood cell count in the peritoneal fluid on admission and isolation of Candida albicans from a peritoneal fluid culture. Intravenous fos-fluconazole was immediately started, although it was ineffective for his deteriorating symptoms. The concomitant isolation of Candida albicans in a stool culture suggested that fungal peritonitis had an enteric origin. An emergency laparotomy revealed multiple diverticulosis and sigmoid colon diverticulitis. A surgical drainage was performed in addition to peritoneal catheter removal. Postoperatively, the patient's symptoms improved rapidly and there were no signs of recurrence with continuous administration of fos-fluconazole. Surgical drainage accelerated the recovery from fungal peritonitis. This patient is the first case showing the usefulness of stool culture in the diagnosis of fungal peritonitis secondary to prior bacterial peritonitis. This case also demonstrated the importance of laparotomy to confirm the enteric origin of the fungus, and the efficacy of early surgical drainage for the treatment. Japanese Society of Nephrology, 2011 Fungal peritonitis secondary to prior bacterial peritonitis nationallicence Peritonitis of enteric origin nationallicence Diverticulitis nationallicence Surgical drainage nationallicence Kazama Itsuro Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut Muto Shigeaki Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut Inoue Makoto Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut Fukui Taro Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut Kotoda Atsushi Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut Takemura Katsumi Takemura Nephrology Clinic, Nishimoro, Kanuma, Tochigi, Japan aut Kimura Takaaki Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut Ishikawa Nobuo Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut Yagisawa Takashi Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut Yumura Wako Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut Kusano Eiji Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut Clinical and Experimental Nephrology Springer Japan 15/6(2011-12-01), 957-961 1342-1751 15:6<957 2011 15 10157 https://doi.org/10.1007/s10157-011-0507-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-011-0507-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kazama Itsuro Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Muto Shigeaki Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Inoue Makoto Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Fukui Taro Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Kotoda Atsushi Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Takemura Katsumi Takemura Nephrology Clinic, Nishimoro, Kanuma, Tochigi, Japan aut NATIONALLICENCE 700 1- Kimura Takaaki Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Ishikawa Nobuo Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Yagisawa Takashi Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Yumura Wako Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Kusano Eiji Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/6(2011-12-01), 957-961 1342-1751 15:6<957 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer