真菌性腹膜炎を発症した糖尿病CAPD患者4例の検討

概要

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A fungal peritonitis is one of the most serious complications for the patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Our study consisted of 103 cases of CAPD with diabetes, and four episodes of fungal peritonitis were observed. The incidence of fungal peritonitis was 0.015 episodes per patient year. The patients were 42～65 years old, three men and one women. All patients had type 2 diabetes and duration of diabetes was 12～22 years. They had fungal peritonitis 12, 24, 25 and 54 months after the initiation of CAPD respectively. The causative fungi of peritonitis were Candida albicans in one case, Candida parapsolosis in the other three cases. All patients were treated with Fluconazole, their PD catheters were removed, and all patients were switched from CAPD to hemodialysis. Two of the patients restarted CAPD again 13 and 40 months respectively after they had PD catheters removed. Moreover, all of them had had bacterial peritonitis or a bacterial CAPD related infection before they had fungal peritonitis. All four CAPD patients who had fungal peritonitis were medicated with some antibacterial agents for bacterial infection prior to fungal peritonitis. This suggested that using antibacterial agents may be an influencing factor in the occurrence of fungal peritonitis in CAPD patients.
東京女子医科大学の論文