Along came a spider: an unusual organism identified in a peritoneal dialysis patient, a case report and literature review

Abstract Background Peritoneal dialysis-associated peritonitis can uncommonly be caused by fungal infections. When they do present, they are associated with significant mortality and morbidity. We describe a case where a sample of peritoneal dialysate fluid grew Rhodotorula muciliginosa, a yeast org...

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Main Authors: Victoria Jane Carnall, Stephanie Murdock, Cressida Auckland, Christopher J. Mulgrew
Format: Article
Language:English
Published: BMC 2020-11-01
Series:BMC Nephrology
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12882-020-02099-8
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spelling doaj-bde20379e5ff4e5ba3ca19450d8403a72020-11-25T04:08:24ZengBMCBMC Nephrology1471-23692020-11-012111510.1186/s12882-020-02099-8Along came a spider: an unusual organism identified in a peritoneal dialysis patient, a case report and literature reviewVictoria Jane Carnall0Stephanie Murdock1Cressida Auckland2Christopher J. Mulgrew3Exeter Kidney Unit, Royal Devon and Exeter Foundation TrustMicrobiology Department, Royal Devon and Exeter Foundation TrustMicrobiology Department, Royal Devon and Exeter Foundation TrustExeter Kidney Unit, Royal Devon and Exeter Foundation TrustAbstract Background Peritoneal dialysis-associated peritonitis can uncommonly be caused by fungal infections. When they do present, they are associated with significant mortality and morbidity. We describe a case where a sample of peritoneal dialysate fluid grew Rhodotorula muciliginosa, a yeast organism present in the normal environment which has previously been reported as rarely causing peritonitis. We believe this is the first case where the Rhodotorula spp. and its origin has been identified. Case presentation A 20 year old male grew Rhodotorula muciliginosa from his peritoneal dialysis fluid on three separate occasions when a fluid sample was sent following a disconnection and subsequent set change. He was not systemically unwell and his peritoneal dialysate was clear. As Rhodotorula spp. is exceedingly difficult to treat our patient had his Tenchkoff catheter removed. Subsequent samples of soil and sand from his bearded dragon and Chilean tarantula cases, kept in his bedroom where dialysis occurred, were tested. The tarantula sand was identified as the source of the Rhodotorula spp. Of note, Candida was isolated from sand from the bearded dragon case. Once his Tenchkoff was removed he was treated with an intravenous course of antifungal therapy. He has since had a new Tenchkoff catheter inserted and recommenced PD following education around pets and hygiene. Conclusions In this era where people are keeping increasingly rare and unusual wildlife in their homes, this case highlights the need for clinician and nursing staff awareness of a patient’s home environment and hobbies when they are undergoing peritoneal dialysis. Sand from our patient’s tarantula case grew the colonising organism but interestingly soil from his bearded dragon case also isolated candida. This can also cause difficult to treat peritonitis.http://link.springer.com/article/10.1186/s12882-020-02099-8PeritonitisPetsFungal infectionRhodotorulaZoonoticCase report
collection DOAJ
language English
format Article
sources DOAJ
author Victoria Jane Carnall
Stephanie Murdock
Cressida Auckland
Christopher J. Mulgrew
spellingShingle Victoria Jane Carnall
Stephanie Murdock
Cressida Auckland
Christopher J. Mulgrew
Along came a spider: an unusual organism identified in a peritoneal dialysis patient, a case report and literature review
BMC Nephrology
Peritonitis
Pets
Fungal infection
Rhodotorula
Zoonotic
Case report
author_facet Victoria Jane Carnall
Stephanie Murdock
Cressida Auckland
Christopher J. Mulgrew
author_sort Victoria Jane Carnall
title Along came a spider: an unusual organism identified in a peritoneal dialysis patient, a case report and literature review
title_short Along came a spider: an unusual organism identified in a peritoneal dialysis patient, a case report and literature review
title_full Along came a spider: an unusual organism identified in a peritoneal dialysis patient, a case report and literature review
title_fullStr Along came a spider: an unusual organism identified in a peritoneal dialysis patient, a case report and literature review
title_full_unstemmed Along came a spider: an unusual organism identified in a peritoneal dialysis patient, a case report and literature review
title_sort along came a spider: an unusual organism identified in a peritoneal dialysis patient, a case report and literature review
publisher BMC
series BMC Nephrology
issn 1471-2369
publishDate 2020-11-01
description Abstract Background Peritoneal dialysis-associated peritonitis can uncommonly be caused by fungal infections. When they do present, they are associated with significant mortality and morbidity. We describe a case where a sample of peritoneal dialysate fluid grew Rhodotorula muciliginosa, a yeast organism present in the normal environment which has previously been reported as rarely causing peritonitis. We believe this is the first case where the Rhodotorula spp. and its origin has been identified. Case presentation A 20 year old male grew Rhodotorula muciliginosa from his peritoneal dialysis fluid on three separate occasions when a fluid sample was sent following a disconnection and subsequent set change. He was not systemically unwell and his peritoneal dialysate was clear. As Rhodotorula spp. is exceedingly difficult to treat our patient had his Tenchkoff catheter removed. Subsequent samples of soil and sand from his bearded dragon and Chilean tarantula cases, kept in his bedroom where dialysis occurred, were tested. The tarantula sand was identified as the source of the Rhodotorula spp. Of note, Candida was isolated from sand from the bearded dragon case. Once his Tenchkoff was removed he was treated with an intravenous course of antifungal therapy. He has since had a new Tenchkoff catheter inserted and recommenced PD following education around pets and hygiene. Conclusions In this era where people are keeping increasingly rare and unusual wildlife in their homes, this case highlights the need for clinician and nursing staff awareness of a patient’s home environment and hobbies when they are undergoing peritoneal dialysis. Sand from our patient’s tarantula case grew the colonising organism but interestingly soil from his bearded dragon case also isolated candida. This can also cause difficult to treat peritonitis.
topic Peritonitis
Pets
Fungal infection
Rhodotorula
Zoonotic
Case report
url http://link.springer.com/article/10.1186/s12882-020-02099-8
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