Skip to main content
Log in

Fatal fungal peritonitis in an adolescent on continuous ambulatory peritoneal dialysis: association with deferoxamine

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

An unusual case ofRhizopus microsporus (mucormycosis) fungal infection in a teenage boy on continuous ambulatory peritoneal dialysis is presented. Premortem cultures were negative and the patient developed a rapidly disseminated fatal infection. The patient was being treated with deferoxamine (DFO) for iron and aluminum overload. An argument is made for a probable association between DFO and this fatal fungal infection in patients with end-stage renal disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Fine RN, Salusky IB, Hall T, Lucillo L, Jordan S, Ettenger R, (1983) Peritonitis in children undergoing continuous ambulatory peritoneal dialysis. Pediatrics 71: 806–809

    Google Scholar 

  2. Mc Clung M (1983) Peritonitis in children receiving continuous ambulatory peritoneal dialysis. Pediatr Infect Dis J 2: 328–332

    Google Scholar 

  3. Hogg RJ, Arant BS, Hauser MT (1982) Candida peritonitis in children on continuous ambulatory peritoneal dialysis. Int J Pediatr Nephrol 3: 287–291

    Google Scholar 

  4. Kerr C, Perfect JR, Craven P, Jorgensen J, Drutz D, Shelburne S, Gallis H, Jutman R (1983) Fungal peritonitis in patients on CAPD. Ann Intern Med 99: 334–337

    Google Scholar 

  5. Oh SE, Conley SB, Rose GM, Rosenblum M, Kohl S, Pickering L (1985) Fungal peritonitis in children undergoing peritoneal dialysis. Pediatr Infect Dis J 4: 62–66

    Google Scholar 

  6. Eisenberg ES, Leviton I, Soeiro R (1986) Fungal peritonitis in patients receiving peritoneal dialysis: Experience with 11 patients and review of the literature. Rev Infect Dis 8: 309–321

    Google Scholar 

  7. Veis J, Contiguglio R, Klein M, Michell S, Olfrey A, Shapiro J (1986) Mucormycosis associated with desferoxamine use in hemodialysis patients. Am Soc Nephrol (Abstract)

  8. Goodhill JJ, Abuelo JG (1987) Mucormycosis. A new risk of deferoxamine therapy in dialysis patients with aluminum or iron overload? N Engl J Med 317: 54

    Google Scholar 

  9. Windus DW, Stokes TJ, Julian BA, Fenves AL (1987) Fatalrhizopus infections in hemodialysis patients receiving deferoxamine. Ann Intern Med 107: 678–80

    Google Scholar 

  10. Hartman BJ (1986) Fungal pritonitis. Infect Surg: 27–36

  11. Warady BA, Campoy SE, Gross SP, Sedman A, Lum G (1984) Peritonitis with continuous peritoneal dialysis and continuous cycling peritoneal dialysis. J Pediatr 105: 727–730

    Google Scholar 

  12. Southwest Pediatric Nephrology Study Group (1985) Continuous ambulatory and continuous cycling peritoneal dialysis in children. Kidney Int 27: 558–564

    Google Scholar 

  13. Straatsma BR, Zimmerman LE, Grass JDM (1962) Phycomycosis, a clinicopathologic study of fifty-one cases. Lab Invest 11: 963–985

    Google Scholar 

  14. Lehrer RI, Howard DH, Sypherd PS, Edwards S, Segal G, Winston D (1980) Mucormyucosis. Ann Intern Med 93: 93–108

    Google Scholar 

  15. Klein MW (1985) Mucormycosis in children: review of the literature and report of cases. Pediatr Infect Dis J 4: 672–676

    Google Scholar 

  16. Donris JE, Rhodes KH, Cooney DR, Roberts GD (1980) Nosocomial Rhizopus infection (zygomyucosis) in children. J Pediatr 96: 824–828

    Google Scholar 

  17. Meyer R, Rosen P, Armstrong D (1972) Phycomycosis complicating leukenia and lymphoma. Ann Intern Med 77: 871–879

    Google Scholar 

  18. Bodey GP (1986) Infection in cancer patients. Am J Med 81 (A): 11–25

    Google Scholar 

  19. Meyer RD, Armstrong D (1973) Mucormycosis: changing status. Crit Rev Clin Lab Sci 4: 421–451

    Google Scholar 

  20. Vas SI (1983) Microbiologic aspects of CAPD. Kidney Int 23

  21. Diamond RD, Krzesicki R, Epstein B, Jao W (1978) Damage to hyphal forms of fungi by human leukocytes in vitro. Am J Pathol 91: 313–323

    Google Scholar 

  22. Bruun JN, Sooberg CO, Hambre E, Janssen C Jr, Arnold S, Eide J (1976) Acute disseminated phycomycosis in a patient with impaired neutrophil granulocyte function. Acta Pathol Microbiol Scand 84: 93–99

    Google Scholar 

  23. Kurz P, Kohler H, Meuer S, Hutteroth T, Meyer K (1986) Impaired cellular immune responses in chronic renal failure: evidence for a T cell defect. Kidney Int 29: 1209–1214

    Google Scholar 

  24. Charpentier B, Lang PH, Martin B, Noury J, Mathieu D, Fries D (1983) Depressed polymorphonuclear leukocyte function associated with normal cytotoxic functions of T and natural killer cells during chronic hemodialysis. Clin Nephrol 19: 288–294

    Google Scholar 

  25. Verbrugh HA, Keane WF, Hoidal JR (1983) Peritoneal macrophages and opsonins: antibacterial defense in patients undergoing chronic peritoneal dialysis. J Infect Dis 147: 1018–29

    Google Scholar 

  26. Barry DMJ, Reeve AW (1977) Increased incidence of gram negative neonatal sepsis with intramuscular iron administration. Pediatrics 60: 908–912

    Google Scholar 

  27. Melby K, Slurdahl S, Sutteberg TJ, Nordbo SA (1982) Septicaemia due toYersinia enterocolitica after oral overdose of iron. Br Med J 295: 467–468

    Google Scholar 

  28. Chiu HY, Flynn DM, Hoffbrand AV (1986) Infection withYersinia enterocolitica in patients with iron overload. Br Med J 292: 97

    Google Scholar 

  29. Robins-Browne RM, Prpic JK (1983) Desferrioxamine and systemic yersinosis. Lancet II: 1373

    Google Scholar 

  30. Andreoli SP, Dunn D, DeMyer W, Shenard D, Bergstein S (1985) Intraperitoneal desferoxamine therapy for aluminum intoxication in a child undergoing continuous ambulatory peritoneal dialysis. J Pediatr 107: 760–763

    Google Scholar 

  31. Falk RJ, Mattern WP, Lamanna RW, Littleman H, Parker N, Cross R, Rastall J (1983) Iron removal during continuous ambulatory peritoneal dialysis using desferoxamine. Kidney Int 24: 110–112

    Google Scholar 

  32. Carotenuto P, Pontesilli O, Cambier JC, Hayward AR (1986) Desferoxamine blocks IL-2 receptor expression on human T lymphocytes. J Immunol 136: 2342–2347

    Google Scholar 

  33. Lederman HM, Cohen A, Lee JWW, Freedman M, Gelband E (1984) Desferoxamine: a reversible S-phase inhibitor of human lymphocyte proliferation. Blood 64: 748–753

    Google Scholar 

  34. Bullen JJ (1981) The significance of iron in infection. Rev Infect Dis 3: 1127–1138

    Google Scholar 

  35. Bowern N, Ranshaw IA, Badench-Jones P, Doherty PC (1984) Effect of an iron chelating agent on lymphocyte proliferation. Aus J Exp Biol Med Sci 62: 743–754

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nakamura, M., Weil, W.B. & Kaufman, D.B. Fatal fungal peritonitis in an adolescent on continuous ambulatory peritoneal dialysis: association with deferoxamine. Pediatr Nephrol 3, 80–82 (1989). https://doi.org/10.1007/BF00859631

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00859631

Key words

Navigation