PD-related peritonitis from Psathyrella candolleana caused by poor PD catheter belt hygiene.

Abstract

Peritoneal dialysis (PD)-associated fungal peritonitis, although rare, presents significant challenges in diagnosis and management. Here, we present the first case of PD-related peritonitis attributed to Psathyrella candolleana and highlight a potential route of infection through contamination from the PD catheter belt. A 37-year-old female, with a history of heart and lung transplantation and undergoing continuous ambulatory PD, presented with acute abdominal pain and cloudy PD effluent (PDE). Genetic analysis of PDE and PD catheter tip confirmed diagnosis of P. candolleana. Treatment was successful without any relapses with timely PD catheter removal and an extended course of antifungal therapy. The root cause analysis suspected the dirt-stained PD catheter belt as the origin of contamination. In conclusion, this is the first case of P. candolleana infection in PD-related peritonitis. Preventive strategies should prioritize hygiene practices, including the PD belt to mitigate the risk of contamination and subsequent infections of such pathogens.