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Journal of Clinical Microbiology, July 1998, p. 2157-2163, Vol. 36, No. 7
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Fatal Hormonema dematioides Peritonitis in a Patient on Continuous Ambulatory Peritoneal Dialysis: Criteria for Organism Identification and Review of Other Known Fungal Etiologic Agents

Jong Hee Shin,1 Sang Ku Lee,1 Soon Pal Suh,1 Dong Wook Ryang,1 Nam Ho Kim,1 Michael G. Rinaldi,2,3 and Deanna A. Sutton3,*

Departments of Clinical Pathology and Internal Medicine, Chonnam University Medical School, Kwangju, Korea,1 and Audie L. Murphy Division, South Texas Veterans Health Care System,2 and Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio,3 San Antonio, Texas 78284

Received 2 January 1998/Returned for modification 9 March 1998/Accepted 7 April 1998

We report a fatal case a fungal peritonitis caused by the yeast-like dematiaceous mould Hormonema dematioides in a 45-year-old woman. The woman had a 13-year history of insulin-dependent diabetes mellitus and had been on continuous ambulatory peritoneal dialysis for chronic renal failure. H. dematioides was repeatedly isolated from the dialysate culture specimens collected on days 3, 9, 16, and 20 of her hospital stay. Preliminary culture reports on day 7 of the growth of a yeast-like fungus, a probable Candida species, prompted the administration of fluconazole (FLU). Intraperitoneal and intravenous FLU failed to eliminate the mould, and the patient expired on day 21 of her hospital stay. We use this case to present what appears to be the first report of fungal peritonitis due to H. dematioides, to provide laboratorians with criteria for differentiating this organism from the similar mould Aureobasidium pullulans and from various yeast genera, and to provide a review of known fungal taxa inciting peritonitis.

* Corresponding author. Mailing address: Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78284-7750. Phone: (210) 567-4131. Fax: (210) 567-4076. E-mail: suttond{at}uthscsa.edu

Journal of Clinical Microbiology, July 1998, p. 2157-2163, Vol. 36, No. 7
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.




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