Korean Journal of Nephrology 1996;15(3):413-418.

진균성 복막염의 임상상에 대한 고찰

김난희 , 권영주 , 이은미 , 김경민 , 김용섭 , 구자룡 , 표희정 , 김형규

Abstract

Among the CAPD peritonitis, fungal peritonitis is relatively rare but the prognosis is poor and the removal of peritoneal catheter is frequent treatment modality. We evaluated the risk factors, treatments, and outcomes between 15 episodes of fungal peritonitis in 15 patients and 115 episodes of bacterial peritoni- tis in 49 patients during the past 4 years. 1) There was no difference in age, sex, and underlying disease between two groups(p>0.05). 2) Fungal peritonitis was caused by Candida spe- cies(7), Trichosporon(3), Cryptococcus(2), Torulopsis (2), and Aspergillus(1). Bacterial peritonitis was caused by MSS(37), MRS(2), other gram positive species(2), Pseudomonas(24), and other gram nega- tive species(25). 3) The incidence of preceding peritonitis(episo- des/month) was 0.18 vs 0.14(p<0.05) and the inci- dence of preceding exit-site infection(episodes/ month) was 0.02 vs 0.03(p>0.05). 4) The median time from the onset of CAPD to peritonitis episode was 150(15-720) days vs 300(15- 1920) days(p>0.05), the median time from the latest peritonitis was 26(0-135) days vs 90(3-1200) days (p<0.05) and the median time from the ceasing of antibiotics was 10(0-120) days vs 72.5(0-1185) days (p<0.05). Fungal peritonitis was occurred within 1 month after ceasing of antibiotics in 8 of 10 patients who had experienced previous bacterial peritonitis (p<0.05). 5) The mean duration of CAPD was 8.8 months vs 19.6 months(p<0.05). 6) The treatment of fungal peritonitis was ca- theter removal with or without antifungal agent. Treatment outcomes were similar between these two treatment modalities. In conclusion, fungal peritonitis was preceded more bacterial peritonitis episodes than control group and occurred mostly within 1 month after ceasing of antibiotics. The episodes of fungal peritonitis was treated by catheter removal with or without antifungal agent. There was no significant difference in morbidity and mortality between these two treatment modalities.