Penicillium peritonitis in a patient receiving continuous ambulatory peritoneal dialysis.
Qadir MT. Cunha BA.
Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501, USA.
Infection is a common complication in patients who receive continuous ambulatory peritoneal dialysis (CAPD). Fungi causing peritonitis in these patients is less common compared with bacterial peritonitis. Fungal peritonitis accounts for less than 10% of cases in chronic CAPD, which usually follows either bacterial peritonitis or earlier exposure to broad-spectrum antibiotics. Most of these cases are caused by Candida albicans or other Candida species. There are only two case reports of Penicillium species peritonitis in patients with CAPD in the literature. We report the known third case of Penicillium species-related peritonitis in a patient receiving CAPD. The patient's condition improved dramatically after catheter removal.
Case presentation: a gastroventricular fistula resulting from peptic ulcer disease.
Coronary Intensive Care Unit, Miami Valley Hospital, Dayton, Ohio, USA.
Gastroventricular fistula is rarely entertained in the differential diagnoses of gastrointestinal bleeding. In fact, most diagnoses are made during postmortem examinations. This article presents a patient who had a gastroventricular fistula develop, and with prompt surgical intervention, had a successful outcome. This patient also may be the only known survivor of such a catastrophic event. This article also discusses the predisposing factors that, when combined with uncontrollable gastrointestinal hemorrhage, suggest a diagnosis of gastroventricular fistula. A high degree of suspicion is required for early diagnosis, prompt surgical repair, and survival.