Fungal Peritonitis

Fungal Peritonitis – General Information

Peritonitis is the inflammation of the peritoneum (the peritoneum is the serous membrane which lines a part of the abdominal cavity). Peritonitis may be localized or generalized. The appearance and development of the Peritonitis may be due either to an infection (which is usually caused by the rupture of a hollow viscus) or to a non-infectious process. This disease is considered to be a surgical emergency. The diagnosis of peritonitis is based on the clinical manifestations. If the patient’s signs and symptoms support the suspicion of this disease then the surgery should not be delayed. The Fungal Peritonitis is an uncommon (but not rare) and serious complication of the peritoneal dialysis (also abbreviated PD) which is associated with a significant rate of mortality. The risk factors of developing Fungal Peritonitis are the followings: immunosuppressed state, malnutrition, age, gender, peritoneal dialysis, underlying disease, residual renal function and albumin and diabetes mellitus. Unfortunately, there is no therapy for the Fungal Peritonitis, and the majority of the hospitals and clinics which confront this kind of case usually use a combination of therapies which are not successful all the time. Many doctors usually recommend the immediate removal of the catheter as it is contaminated with fungi. The rate of appearance and development of this medical condition was studied on 420 of patients which were under treatment with peritoneal dialysis and the doctors discovered that 5.7% of the cases in which this medical condition appeared were caused by fungi. Unfortunately the treatment was successful only for 40 patients; this is why an early diagnosis and an appropriate treatment decrease the rate of mortality.

Fungal Peritonitis – Symptoms

It is a well known fact that any medical disorder (including Fungal Peritonitis) can trigger a variety of symptoms. Therefore, some of this medical condition's most uncommon symptoms have not been listed (mentioned) here. This is why we strongly recommend you to contact your personal health care provider whenever you develop any unusual, bothersome or unpleasant symptoms. Your personal physician will be able to tell you if you are suffering from Fungal Peritonitis or from any other medical disorder. Here is a list of the most common symptoms that a person who suffers from Fungal Peritonitis, may experience: weakness, chills and fever with profuse perspiration, pale and cold skin, shock, swollen and bloated abdomen, abdominal pain and severe abdominal pain, high fever, shivering, hot skin, acute onset of severe and steady pain in the abdomen zone, board like rigidity of the abdomen (this is due to the contraction of the muscle of the abdominal pain), hard abdominal muscle, silent abdomen, shallow breathing, rapid breathing, rapid pulse and low blood pressure. Other symptoms that the patients who are suffering from this medical disorder are the followings: severe and generalized abdominal pain, vomiting, no bowel sounds, almost 30% of the patients have positive blood cultures, cloudy peritoneal effluent, low urine output, fluid in the abdomen, joint pain, nausea. But as we said before each individual experience this symptoms differently this is why we strongly recommend you, in the case in which you experience some of the symptoms listed above to see you doctor for further investigation.

Fungal Peritonitis – Treatment

The Fungal Peritonitis is usually secondary to an underlying abdominal condition and the management of this medical condition needs the management of the underlying disease, this means that the correct antibiotic therapy depends on the identification of the underlying condition. The management of the Fungal Peritonitis is usually done with Laparatomy (also known drainage), systemic antibiotics, nutrition, support of the falling organs and aggressive fluid administration. The patient’s characteristic may provide a clue that leads to the causative organism, for example if a patient has been hospitalised for a period of time, the doctors usually take into consideration Pseudomonas. Combination therapy is usually requires, as the combination therapy provides a broad spectrum activity which is needed for polymicrobial infections. It is necessary for the treatment to have coverage for Escherichia Coli and other Gram-negative anaerobes. The initial therapy is based on cephalosporin such as cefuroxime and metronidazole if the condition of the patients is well. If the condition of the patient begins to deteriorate or in the cases in which the disease is serious from the beginning, there are 2 options of treatment: cefuroxime, metronidazole plus Ampicilin (or Amoxicillin).

In the cases in which the condition is severe, the patients are recommended to go and see a microbiologist because the treatment and therapy depends on the local resistance patterns. Usually intravenously therapy is recommended until the gastro-intestinal functions are restored. We intend to present you some drugs which are usually recommended to the patients with Fungal Peritonitis. Diflucan is an antifungal antibiotic used to treat the infections which are caused by fungus (which can be localized in the mouth, throat, esophagus, lungs, bladder, genital area and blood) and also to prevent them in the people with a weak immune system (the weakened immune system may be the result of a cancer treatment, bone marrow transplant or diseases like AIDS). Before taking this medicine the patients should tell the doctor if they are allergic to any of the constituents of Diflucan and also if they have liver or kidney disease, a heart rhythm disorder, or a family/personal history of a “Long QT syndrome”, because the patient has any of these conditions he is either unable to take this drug or he needs a dose adjustment or some special tests in order to safely take this medicine. It is also well known the fact that this medicine is harmful to an unborn child, so if the patient is pregnant she must tell the doctor and even if she is breast-feeding.

Fluconazole is a medicine that is used to treat serious fungus infections which can appear in different parts of the body (including Fungal Peritonitis), but it may also be used in other purposes. This medicine should not be taken by persons who are allergic to any of the constituents of Fluconazole, children, older adults, pregnant women and breast-feeding women.