MANAGEMENT OF FUNGAL PERITONITIS DURING CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD)

A group of 138 patients (pts) on CAPD for a total of 1889 patientmonths had 176 episodes of peritonitis. Eighteen (13% ) had fungal peritonitis at one to 20 months after beginning CAPD. The responsible organisms were Candida albicans (nine pts), Candida parapsilosis (five), Candida torulopsis (three), and Trichosporum capitatum (one). These infections were treated by various combinations of antifungal agents using two different strategies: Removal of the Tenckhoff catheter and interruption of CAPD for 10 to 14 days in nine pts (Group A), and continuous peritoneal lavage for four to six days in the remainder -nine pts (Group B). Fourteen of the 18 were cured (seven of nine in each group). In group A, two patients died, one continues on CAPD while the other six (67% ) were transferred to hemodialysis because they developed peri 2nd Prop. Dept. ofMedicine, Aristotelian University of Thessaloniki, Thessaloniki, Greece. *Visiting professor from Georgetown University Medical Center, Washington, D.C.