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Peritoneal dialysis-related peritonitis caused by Fusarium: a case report and literature review

Summary

A 61-year-old farmer with kidney disease on peritoneal dialysis developed a rare fungal infection caused by Fusarium, a fungus found in soil and water. After initial antibiotics failed, doctors identified the fungus and switched to an antifungal medication called voriconazole. By carefully monitoring drug levels in the patient’s blood and adjusting doses, pharmacists helped achieve a successful recovery with complete resolution of symptoms.

Background

Fungal peritonitis is a significant complication of peritoneal dialysis (PD) that can result in severe consequences. However, peritonitis caused by Fusarium species is relatively rare with limited literature on standard treatment approaches.

Objective

To report a case of PD-related Fusarium peritonitis and review the literature to establish treatment protocols. The study aimed to demonstrate the role of clinical pharmacists in managing this rare fungal infection through therapeutic drug monitoring.

Results

The patient initially failed empirical bacterial antibiotic therapy. Fusarium species was identified on day 23 of hospitalization. Oral voriconazole with therapeutic drug monitoring achieved plasma concentrations above 2 μg/ml. The patient achieved favorable outcomes with resolution of abdominal pain, normalization of inflammatory markers, and complete clinical remission at 2-month follow-up.

Conclusion

PD-related Fusarium peritonitis is rare with limited treatment consensus. Oral voriconazole combined with therapeutic drug monitoring effectively managed this case. Rapid diagnostic assays and comprehensive literature-based personalized antifungal regimens are essential for managing rare fungal peritonitis in PD patients.
  • Published in:Fungal Biology,
  • Study Type:Case Report and Literature Review,
  • Source: PMID: 41036233, DOI: 10.3389/ffunb.2025.1637498
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