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Successful Treatment of Paecilomyces variotii Peritonitis in a Liver Transplant Patient

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Abstract

Paecilomyces variotii has previously been reported as a causative pathogen for peritonitis in patients on continuous ambulatory peritoneal dialysis and shown to be usually sensitive to amphotericin B and resistant to voriconazole. We report the first case, to our knowledge, of P. variotii peritonitis in a liver transplant patient, which was unresponsive to initial liposomal amphotericin B (L-AmB) treatment and resolved dramatically after the addition of voriconazole. The present case provides evidence for the clinical and microbiological effectiveness of voriconazole combined with L-AmB in treating P. variotii peritonitis refractory to initial L-AmB treatment.

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References

  1. Pastor FJ, Guarro J. Clinical manifestations, treatment and outcome of Paecilomyces lilacinus infections. Clin Microbiol Infect. 2006;12:948–60.

    Article  CAS  PubMed  Google Scholar 

  2. Houbraken J, Verweij PE, Rijs AJ, Borman AM, Samson RA. Identification of Paecilomyces variotii in clinical samples and settings. J Clin Microbiol. 2010;48:2754–61.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Wright K, Popli S, Gandhi VC, Lentino JR, Reyes CV, Leehey DJ. Paecilomyces peritonitis: case report and review of the literature. Clin Nephrol. 2003;59:305–10.

    Article  CAS  PubMed  Google Scholar 

  4. Castelli MV, Alastruey-Izquierdo A, Cuesta I, Monzon A, Mellado E, Rodriguez-Tudela JL, et al. Susceptibility testing and molecular classification of Paecilomyces spp. Antimicrob Agents Chemother. 2008;52:2926–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Pungpapong S, Alvarez S, Hellinger WC, Kramer DJ, Willingham DL, Mendez JC, et al. Peritonitis after liver transplantation: incidence, risk factors, microbiology profiles, and outcome. Liver Transpl. 2006;12:1244–52.

    Article  PubMed  Google Scholar 

  6. Bartoletti M, Cervera C, Hoyo I, Linares L, Sanclemente G, Bosch J, et al. Incidence and outcome of early Candida peritonitis after liver and pancreas transplantation. Mycoses. 2013;56:162–7.

    Article  PubMed  Google Scholar 

  7. Chang BP, Sun PL, Huang FY, Tsai TC, Lin CC, Lee MD, et al. Paecilomyces lilacinus peritonitis complicating peritoneal dialysis cured by oral voriconazole and terbinafine combination therapy. J Med Microbiol. 2008;57:1581–4.

    Article  PubMed  Google Scholar 

  8. Aguilar C, Pujol I, Sala J, Guarro J. Antifungal susceptibilities of Paecilomyces species. Antimicrob Agents Chemother. 1998;42:1601–4.

    PubMed Central  CAS  PubMed  Google Scholar 

  9. Prasad N, Gupta A. Fungal peritonitis in peritoneal dialysis patients. Perit Dial Int. 2005;25:207–22.

    PubMed  Google Scholar 

  10. Chamilos G, Kontoyiannis DP. Voriconazole-resistant disseminated Paecilomyces variotii infection in a neutropenic patient with leukaemia on voriconazole prophylaxis. J Infect. 2005;51:225–8.

    Article  Google Scholar 

  11. Sandoval-Denis M, Pastor FJ, Capilla J, Guarro J. Efficacy of amphotericin B at suboptimal dose combined with voriconazole in a murine infection by Aspergillus fumigatus with poor in vivo response to the azole. Antimicrob Agents Chemother. 2013;57:4540.

    Article  PubMed Central  CAS  Google Scholar 

  12. Antachopoulos C, Papakonstantinou E, Dotis J, Bibashi E, Tamiolaki M, Koliouskas D, et al. Fungemia due to Trichosporon asahii in a neutropenic child refractory to amphotericin B: clearance with voriconazole. J Pediatr Hematol Oncol. 2005;27:2835.

    Article  Google Scholar 

  13. Crum-Cianflone NF. Voriconazole in combination with amphotericin B for salvage therapy of coccidioidomycosis. Case report and review of the literature. Infect Dis Clin Pract. 2007;15:265–8.

    Article  Google Scholar 

  14. Hosokawa K, Yamazaki H, Mochizuki K, Ohata K, Ishiyama K, Hayashi T, et al. Successful treatment of Trichosporon fungemia in a patient with refractory acute myeloid leukemia using voriconazole combined with liposomal amphotericin B. Transpl Infect Dis. 2012;14:184–7.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Meltem Polat.

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Polat, M., Kara, S.S., Tapısız, A. et al. Successful Treatment of Paecilomyces variotii Peritonitis in a Liver Transplant Patient. Mycopathologia 179, 317–320 (2015). https://doi.org/10.1007/s11046-014-9854-1

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  • DOI: https://doi.org/10.1007/s11046-014-9854-1

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