Document Detail


Successful treatment of mucormycosis peritonitis with liposomal amphotericin B in a patient on long-term peritoneal dialysis.
MedLine Citation:
PMID:  12955706     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 42-year-old man, with a history of immunoglobulin A nephropathy, underwent a living-related kidney transplant. Allograft function progressively deteriorated secondary to chronic rejection and recurrence of IgA nephropathy, and he returned to peritoneal dialysis after 5 years of the transplant. Fifteen months after the discontinuation of immunosuppressive therapy, Eschericia coli peritonitis developed, which was treated with ceftazidime intraperitoneally; he received fluconazole as prophylactic antifungal therapy during this period. After completing his course of treatment, abdominal pain occurred with an increased peritoneal fluid white blood cell count. Peritoneal fluid cultures were negative. He received broad-spectrum antibiotics and fluconazole with no appreciable response. After removal of the Tenckoff catheter, peritoneal fluid cultures grew a zygomycete. The patient was treated with liposomal amphotericin B (AmBisome) intravenously for 6 weeks. He had episodes of recurrent intraabdominal abscesses requiring surgical drainage and antibiotics. A second course of liposomal amphotericin B was administered for histopathologic evidence of filamentous fungal recurrence. After 5 months, the patient remains well without any evidence of infection.
Authors:
Jorge H Serna; Audrey Wanger; Akinsansoye K Dosekun
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  42     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-04     Completed Date:  2004-01-08     Revised Date:  2008-09-25    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E14-7     Citation Subset:  IM    
Affiliation:
Department of Renal Diseases and Hypertension, University of Texas Health Science Center at Houston, Houston, TX, USA.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Abscess / drug therapy,  etiology,  surgery
Amphotericin B / therapeutic use*
Antifungal Agents / therapeutic use*
Bacteroides fragilis
Combined Modality Therapy
Drug Therapy, Combination / therapeutic use
Fluconazole / therapeutic use
Glomerulonephritis, IGA / surgery,  therapy
Graft Rejection
Gram-Negative Bacterial Infections / drug therapy,  etiology
Humans
Immunosuppressive Agents / adverse effects,  therapeutic use
Kidney Transplantation
Male
Mucormycosis / drug therapy*,  etiology
Peritoneal Dialysis / adverse effects*
Peritonitis / drug therapy*,  etiology
Recurrence
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Immunosuppressive Agents; 0/liposomal amphotericin B; 1397-89-3/Amphotericin B; 86386-73-4/Fluconazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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