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BÎR SÜREKLİ AYAKTAN PERİTON DİYALİZİ HASTASINDA ASPERGILLUS NIGER PERİTONİTİ

PERITONITIS DUE TO ASPERGILLUS NIGER IN A CHILD ON CONTINUOUS AMBULATORY PERITONEAL DIALYSIS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1997

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
Peritonitis is the most frequently encountered seri¬ous complication of continuous ambulatory peritoneal dialysis (CAPD). Fungal peritonitis is relatively uncommon and Aspergillus Niger peritonitis is extremely rare in CAPD patients. A 12-year-old girl with rapidly progressive glomerulonephritis was started on CAPD programme in April 1994 despite of pulse methyl-prednisolone and cyclophosphamide therapy. During the next four months, she experienced three episodes of catheter drainage problem. Gram stains and cultures of dialy-sate were negative in each episodes. At the fourth epi¬sode, peritoneal fluid was slightly cloudy with nume¬rous cells, predominantly lymphocytes. Cultures of Sa-bouraud's agar of two consecutive specimens ofdialy-sate isolated Aspergillus Niger. The patient was given IVand IP fluconazole for 10 days, then Tenckhoff cat¬heter was removed. Fluconazole was continued only IV, until 17th day of treatment. At this time the Tenc-khoff catheter was reinserted and antifungal therapy was completed for four weeks by IV and IP. The pati¬ent returned successfully CAPD therapy by this proto¬col. With this report, we emphasized that Aspergillus peritonitis could lead the drainage problem in child¬ren and treatment had to be instituted immediately af¬ter diagnosis.
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Abstract (Original Language): 
Peritonit, sürekli ayaktan periton diyalizi (SAPD) hastalarında, yaşamı etkileyen en önemli komplikas-yondur. Fungal peritonitler göreceli olarak az görü¬lürler. Aspergillus Nigerin yol açtığı fungal peritonit¬ler ise nadir olarak ortaya çıkmaktadırlar. Hızlı ilerleyen glomerülonefritli, 12 yaşındaki kız hasta metil-prednizolon pulse ve siklofosfamit tedavi¬lerine karşın, böbrek yetmezliği geliştiği için CAPD programına alındı. Bundan sonraki yaklaşık dört ay¬lık sürede üç kez kateter tıkanması problemiyle hasta¬nemize başvurdu. Gram boyamak preparatlar ve kül¬türlerde herhangi bir mikroorganizma saptanamadı. Hastanın dördüncü kez aynı problemle başvurduğun¬da alman iki ardışık diyalizat örneğinde Aspergillus niger üredi. Hastaya 10 gün IVve İP flukonazol verildikten sonra kateter çekilerek, 17. güne kadar tedavisi yalnız IV flukonazolle sürdürüldü. Onyedinci günde, Tenckhofl kateteri yeniden yerleştirilerek tedavisi IV ve İP dört haftaya tamamlandı. Bundan sonra hastada kateter tıkanması sorunuyla karşılaşılmadı. Bu olgu sunumuyla kateter tıkanması problemi olan SAPD hastalarında fungal peritonit olasılığının hatırlanması ve tanıdan sonra antifungal ilaç kullanı¬mı ve kateter çekilmesini içeren tedavi protokollerinin acilen uygulanmasının önemi vurgulanmak istendi.
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  • 1-2
88-90
  • Turkish

REFERENCES

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