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First human case of Eidernor doerrieniae colonization in a peritoneal dialysis catheter: A warning from silent contamination

Summary

A 52-year-old man on peritoneal dialysis noticed brownish particles in his dialysis catheter. Doctors identified the particles as a rare fungus called Eidernor doerrieniae, which had never been found in humans before. Although the patient had no symptoms, doctors immediately removed the catheter and treated him with antifungal medications, which successfully cured the infection. This case shows why patients and doctors should take visible particles in dialysis catheters seriously, even when there are no obvious signs of infection.

Background

Subclinical intraluminal fungal colonization in peritoneal dialysis (PD) catheters is an underappreciated challenge. While fungal colonization of medical devices has been documented, evidence for such colonization in PD catheters remains scarce with only three cases reported previously. Eidernor doerrieniae has been isolated from environmental sources but has not previously been implicated in human infections.

Objective

To document and characterize the first human case of Eidernor doerrieniae colonization in a peritoneal dialysis catheter and highlight the importance of recognizing visible intraluminal particles as indicators of fungal colonization.

Results

The fungal isolate was identified as E. doerrieniae through DNA sequencing with 100% query coverage and 99.8% sequence identity. Colonies exhibited cerebriform morphology by day 7. The isolate was susceptible to amphotericin B and isavuconazonium but resistant to multiple azoles and caspofungin. Prompt catheter removal and antifungal therapy (amphotericin B followed by fluconazole) successfully resolved the infection without peritonitis development.

Conclusion

This first documented human infection with E. doerrieniae emphasizes the importance of recognizing visible intraluminal particles as critical indicators of fungal colonization, even in asymptomatic patients. Timely catheter removal and antifungal therapy are essential to prevent progression to fungal peritonitis, and multi-targeted molecular diagnostics are valuable for identifying uncommon fungal pathogens.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: PMID: 40041545
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