A case of candida peritonitis followed by mediastinitis after esophageal perforation in a peritoneal dialysis patient
Tanaka, M.; Ono, T.; Takeda, T.; Watanabe, H.; Muso, E.; Sasayama, S.
Peritoneal Dialysis International Journal of the International Society for Peritoneal Dialysis 21(3): 316
2001
ISSN/ISBN: 0896-8608 PMID: 11475350 Document Number: 534012
A 52-year-old man from Japan with dilated cardiomyopathy was admitted to a hospital in December 1997 for congestive heart failure and renal failure. On admission, he was unconscious due to shock with oliguria. His serum creatine and blood urea nitrogen levels were 620 micro mol/litre and 43.2 mmol/litre, respectively. He was started on peritoneal dialysis with four daily exchanges of 2-litre peritoneal dialysate. In May 1998, he developed a low-grade fever accompanied by an elevated C-reactive protein level, and his throat culture was positive for Candida albicans, suggesting oesophageal candidosis. He was given oral itraconazole, which was stopped due to drug-induced ventricular arrhythmia. The dialysate effluent culture revealed C. albicans peritonitis just before he died on 12 October. Postmortem examination showed perforated oesophageal ulcer, mediastinitis and peritonitis.