Abstract
This report describes a case of relapsing Candida peritonitis complicating chronic peritoneal dialysis. The patient was a 16-year-old boy with cerebro-oculo-hepato-renal syndrome who was receiving nocturnal intermittent peritoneal dialysis for chronic renal failure. Fungal peritonitis with Candida albicans developed due to breakage of a connection tube. Since the patient was mentally retarded and unable to lie quietly, the dialysis catheter was replaced and antifungal medication was administered intraperitoneally, without changing to hemodialysis. Peritonitis subsequently improved rapidly, but relapsed twice within a short interval. The catheter was therefore removed and the patient maintained on hemodialysis with concomitant intravenous administration of antifungal agents for 4 weeks. A new dialysis catheter was then re-implanted. No new episodes of peritonitis developed after this treatment. The benefits of prophylactic antifungal treatment and early catheter removal should be elucidated in patients with fungal peritonitis receiving chronic peritoneal dialysis.
