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Fungal peritonitis in a patient on peritoneal dialysis caused by Hyphopichia burtonii: A rare pathogen in human infection

Summary

A woman with kidney disease on peritoneal dialysis developed an unusual fungal infection caused by Hyphopichia burtonii, a fungus typically found in spoiled food. The infection was diagnosed using advanced protein analysis technology and treated with antifungal medication after removing the dialysis catheter. Though extremely rare in humans, this case shows that unusual fungi can cause serious infections in patients with weakened immune systems and highlights the importance of considering these organisms when standard treatments don’t work.

Background

Fungal peritonitis in peritoneal dialysis patients is rare but associated with high morbidity and mortality. Candida species are the most common causative agents, but infections caused by unusual fungi are increasingly reported. Hyphopichia burtonii is typically associated with food spoilage and has rarely been documented in human infections.

Objective

To describe a case of fungal peritonitis caused by Hyphopichia burtonii in a peritoneal dialysis patient and highlight the importance of early identification and appropriate management of this emerging fungal pathogen.

Results

Small, opaque colonies of Hyphopichia burtonii were isolated within 36 hours and identified by MALDI-TOF on Day 2. Following identification, the peritoneal catheter was removed, hemodialysis was initiated, and fluconazole (200 mg intravenously every 12 hours) was administered for 14 days total. The patient showed marked symptom improvement and was discharged in stable condition.

Conclusion

This case highlights that rare fungal organisms such as Hyphopichia burtonii can cause serious infections in peritoneal dialysis patients. Early identification through molecular diagnostics, prompt catheter removal, and appropriate antifungal therapy are critical for successful treatment. Non-Candida fungi should be considered in peritonitis cases and established guidelines for fungal peritonitis management should be followed.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: PMID: 40170764, DOI: 10.1016/j.mmcr.2025.100699
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