PENICILLIUM PERITONITIS IN A CAPO PATIENT

Penicillium peritonitis developed in a CAPD patient who employed poor sterile technique in performing exchanges. Previous antibiotic therapy may have played a contributing role. Physicians caring for CAPD patients should be alerted that fungal colonies and strands may mimic fibrin in CAPD catheters. Early removal of the catheter, which is the treatment of choice, quickly reversed our patient's peritonitis. Peritonitis is the most troublesome aspect of chronic peritoneal dialysis. We wish to report peritonitis due to an unusual organism; it developed in a patient who was often careless about sterile technique and who, in the recent past, had received antibacterial therapy. CASE REPORT This 50-year old white man first developed signs of renal disease in 1958. In 1975 a renal biopsy, which was done at another center because of persistent proteinuria, revealed focal sclerosing nephropathy. In May 1980, he was referred to us because of hypertension (185/112 mm Hg) and a serum creatinine of 7.5 mg/dl. In October 1980. his renal function further deteriorated and hemodialysis was initiated using a saphenous vein loop in his thigh. However, he was changed to intermittent peritoneal dialysis (IPD) at his own request because of repeated vascular access problems. In December 1980 a Tenckhoff catheter was inserted, and thereafter, following an initial catheter tract leak, he developed a stitch abscess and a