Penicillium peritonitis in continuous ambulatory peritoneal dialysis

Fungal peritonitis can cause high morbidity and mortality in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Penicillium infection is a rare cause of fungal peritonitis. In fact, to the best of our knowledge the two cases reported here bring to eight the total number of cases of Penicillium peritonitis in CAPD patients that have been reported in the English literature. These eight patients have ranged in age from 19-75 yr, and 62.5% have been female. The treatment duration of CAPD ranged from 10 mo to 10 yr. A history of recent bacterial peritonitis occurred in half the cases, and 87.5% of the cases had a recent history of antibiotics use. All cases had a predominance of polymorphonuclear cells in the peritoneal fluid. A positive smear for fungus was found in only two cases. All of the peritoneal Tenckhoff catheters were subsequently removed. Although the anti fungal regimens differed among all the reported cases, all of them recovered after removal of the CAPD catheter and after the administration of drugs. We conclude that Penicillium should be considered a causal agent of fungal peritonitis in CAPD patients.