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Fungal PD Peritonitis — ESENeph MCQ

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ModeratePeritoneal DialysisFungal PD PeritonitisESENeph

A 55-year-old woman on PD has a positive peritoneal fluid culture for fungal organisms (Candida species). She has been on recent antibiotics for a bacterial exit site infection. What is the recommended management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Immediate catheter removal plus systemic antifungal therapy for at least 2 weeks after catheter removal

Fungal peritonitis in PD carries a high morbidity and mortality. ISPD 2022 guidelines recommend immediate PD catheter removal plus systemic antifungal therapy (Fluconazole for Candida, broader cover if resistant species). Antifungal treatment should continue for at least 2 weeks after catheter removal. Delaying catheter removal is associated with worse outcomes. The patient will need temporary haemodialysis during treatment and recovery.

Reference: ISPD 2022 – PD Peritonitis Guidelines