Spontaneous fungal peritonitis (Candida glabrata) in a patient with cirrhosis

Citation
S. Nair et al., Spontaneous fungal peritonitis (Candida glabrata) in a patient with cirrhosis, J CLIN GAST, 32(4), 2001, pp. 362-364
Citations number
15
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenerology and Hepatology
Journal title
JOURNAL OF CLINICAL GASTROENTEROLOGY
ISSN journal
0192-0790 → ACNP
Volume
32
Issue
4
Year of publication
2001
Pages
362 - 364
Database
ISI
SICI code
0192-0790(200104)32:4<362:SFP(GI>2.0.ZU;2-F
Abstract
We report a case of spontaneous fungal peritonitis in a patient with cirrho sis. A 70-year-old woman with cirrhosis secondary to autoimmune hepatitis w as admitted with fever and abdominal distention. Paracentesis revealed neut rocytosis, and despite appropriate antibacterial coverage, no clinical impr ovement was noted and the ascitic fluid white cell count increased on repea t paracentesis. Two consecutive ascitic fluid cultures grew Candida glabrat a, and antifungal therapy with amphotericin was initiated, pending sensitiv ity of the isolate. Because of worsening renal function, amphotericin was d iscontinued and itraconazole was started, as sensitivity of the isolate was then available. Antifungal therapy resulted in resolution of ascitic fluid neutrocytosis and culture negativity. However, the patient's renal functio n continued to deteriorate, necessitating hemodialysis. Despite multiple co urses of antibiotics, she died of fulminant sepsis and multiorgan failure.