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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 dialysis patient noticed brownish particles inside his peritoneal dialysis catheter. Doctors identified a rare fungus called Eidernor doerrieniae using DNA sequencing, which had never been found in humans before. The catheter was removed and the patient received antifungal medications that successfully eliminated the infection without causing serious complications.

Background

Subclinical intraluminal fungal colonization in peritoneal dialysis (PD) catheters is an underappreciated challenge in nephrology. Eidernor doerrieniae, a basidiomycete fungus previously isolated from environmental sources, has not been previously implicated in human infections. Visible intraluminal particles in PD catheters may serve as a crucial clue for early diagnosis.

Objective

To report the first documented human case of E. doerrieniae colonization in a peritoneal dialysis catheter and to highlight the importance of recognizing intraluminal particles as indicators of fungal colonization. The case emphasizes the critical role of timely intervention and advanced molecular diagnostics in preventing fungal peritonitis.

Results

Fungal cultures revealed cerebriform (brain-like) colonies of E. doerrieniae, confirmed through 28S rRNA gene sequencing with 100% query coverage and 99.8% sequence identity. The isolate was susceptible to amphotericin B and isavuconazonium but resistant to multiple azoles and caspofungin. A wet contamination event three weeks prior was identified as the likely source.

Conclusion

Prompt catheter removal combined with intravenous amphotericin B followed by oral fluconazole successfully resolved the infection without peritonitis development. This case underscores the importance of recognizing intraluminal particles as an indicator of fungal colonization, even in asymptomatic patients, and highlights the value of multi-targeted molecular diagnostics in identifying rare fungal pathogens in peritoneal dialysis infections.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: PMID: 40041545
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