治療困難であった真菌性腹膜炎の１例　　ＥＰＳを発症させないために

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  • A case report of resistant fungal peritonitis: Prevention of EPS.

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Treatment of resistant fungal peritonitis was evaluated based on the prevention of encapsulating peritoneal sclerosis (EPS). The patient was a 61-year-old man. In July 1997, CAPD therapy was started for the treatment of chronic renal failure derived from diabetic nephropathy. In February 2000, the CAPD therapy was discontinued because of the onset of fungal peritonitis, and the patient was transferred to hemodialysis. Daily peritoneal lavage and oral and/or intravenous administration of antifungal agents were added to the patient without removing the PD catheter. During the treatment symptoms such as abdominal pain and fever were not observed except for persistent cloudy effluent. The indwelling catheter was removed when the patient was hospitalized in August 2000. Thereafter, the peritonitis was cured, and EPS has not occurred.<br>Resistant fungal peritonitis is one of the risk factors that induce the occurrence of EPS, and cure of the fungal peritonitis is of primary importance. This case suggests that catheter removal immediately after the occurrence of resistant fungal peritonitis is more effective than repeated peritoneal lavage for the treatment, and that it might also be useful for preventing EPS.

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