Treatment of Fungal Peritonitis in CAPO Patients Using Peritoneal Lavage

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Abstract
This paper describes four CAPD patients with fungal peritonitis. The causative fungi were Candida albicans (twice), C. tropicalis and Cryptococcus neoformans. The infections were managed using the following regimen: 1 Removal of the Tenckhoff catheter. 2 Insertion of a temporary peritoneal catheter and commencement of peritoneal lavage, and administration of intraperitoneal miconazole and oral ketoconazole. 3 Insertion of a new Tenckhoff catheter after resolution of the peritonitis. Three of these patients recovered. We believe that it helps to remove the Tenckhoff catheter early and that, with our regimen, we can manage fungal peritonitis without suspending peritoneal dialysis. It appears that a combination of intraperitoneal miconazole and oral ketoconazole constitutes an effective antifungal therapy in CAPD peritonitis.

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