Fungal Peritonitis (FP)

Posted by e-Medical PPT
Empiric diagnosis of peritonitis
Pain, fever and a positive dialysate culture are facultative features of peritonitis.
Dialysate culture results are typically not available before 24 hours and are not helpful in initial clinical decision making.
The criteria represent international consensus among adult and pediatric nephrologists.

How frequent is Fungal Peritonitis?
1% of all episodes of peritonitis

What are the predisposing factors for the development of FP?
Prior use of antibiotics to treat bacterial peritonitis or a catheter-related infection.
Nearly 50% of children who developed fungal peritonitis, have no received antibiotics (for peritonitis, ESI, or other reason)  prior to the peritoneal infection.

How long we should treat FP?
The duration of antifungal treatment following catheter removal should be 2 weeks or longer following complete resolution of the clinical symptoms of infection
(or 4 - 6 weeks without catheter removal)

Fungal peritonitis is a rare complication of peritoneal dialysis (it represents 1% of all episodes of peritonitis)
The optimal management  is early catheter removal and the administration of a variety of anti-fungal agents
The mortality rate is not high in the paediatric population
Preservation of the peritoneal membrane and continuation of PD is feasible with early PD catheter removal and appropriate therapy

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