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Acremonium strictum has been found on many saprotrophic fungi, several plant- pathogenic fungi (Gams ), and on the mycoparasite Mycogone perniciosa. We present a case of a fungal peritonitis caused by Acremonium strictum in patient undergoing continuous ambulatory peritoneal dialysis (CAPD). The most common species in indoor environment are Acremonium strictum and A . charticola. Acremonium strictum is commonly encountered in.

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During the past two decades opportunistic fungal infections have emerged as important causes of morbidity and mortality in patients with severe underlying illnesses. A few cases of Acremonium spp. Peritonitis is a common clinical problem that occurs in patients with end-stage renal disease treated by continous ambulatory peritoneal dialysis CAPD. Yeasts, or rarely molds, may also cause peritonitis in patients on CAPD and we present here a case caused by Acremonium strictum.

Hyaline filamentous fungi which were previously uncommon as disease agents are increasingly encountered as the cause of life threatening invasive infections that are often refractory to conventional therapies 1.

Infections with fungi such as Acremonium species have become significant problems in the treatment of immunocompromised hosts 2.

Acremonium species have been reported to be the cause of localized or disseminated infections in patients with predisposing conditions such as Addison’s disease, neutropenia, immune suppression and intravenous drug abuse 3—5.

We present a case of a fungal peritonitis caused by Acremonium sgrictum in patient undergoing continuous ambulatory peritoneal dialysis CAPD. A year-old woman with diabetes mellitus and chronic renal failure was admitted to the nephrology service of Ataturk Training and Research Hospital with dimness in peritoneal dialysis fluid.

The strictu, primary diagnosis was hypertensive nephropathy of eight years duration and she had been treated by CAPD for five years. Abdominal pain was the main complaint of the patient. Sfrictum examination revealed eudema in the acremonjum region. Tension arterial and pulses were normal. Biochemical findings were as follows: Cultures were inoculated with blood, nasal, peritoneal dialysis fluid and catheter samples.

Staphylococcus aureus was recovered from the nasal specimens. Nasal sstrictum and systemic antibacterial therapy cefazolin and ciprofloxacine were started. Fungal colonies were isolated in cultures inoculated with peritoneal dialysis fluid. Isolation and identification of Acremonium spp. Direct examination of the specimen of the peritoneal actemonium fluid revealed hyphae and leucocytes.


The peritoneal fluid was cultured on sheep blood agar, eosin-methylene-blue agar and Sabouraud dextrose agar. On microscopic examination with lactophenol cotton blue, septate hyphae, conidiogenous cells and needle-shaped awl phialides were seen.

This fungus was identified as Acremonium spp.

Sarocladium strictum

Molecular analysis was not performed. Micromorphology acrfmonium a colony of Acremonium strictum lactophenol cotton blue preparation.

In the last few years there has been an increase acrenonium mycoses caused by opportunistic fungal pathogens 6. Species of the genus Acremonium are widespread soil saprophytes which on rare occasions can be opportunistic pathogens in immunosuppressed individuals 7— The patient failed to strjctum to high dose amphotericin B therapy and died. They successfully treated the patient with amphotericin B, granulocyte colony-stimulating factor G-CSF and surgical drainage.

Disseminated Acremonium shrictum infection in a neutropenic patient was acrmeonium by Schell and Perfect There are only a few reports for disseminated Acremonium infections. They reported that the infections were rapidly fatal despite neutrophil recovery and early antifungal combination therapy with amphotericin B and caspofungin.

In another study, fungal infections of dialysis fistulae were presented in two patients with recurrent infections were acremnoium. Staphylococcus aureus and Acremonium species were isolated from the thromboses of their grafts The authors suggested amphotericin B therapy for fungal infections of dialysis fistulae.

However Mattei et al. Peritonitis is a frequent complication in patients with chronic renal failure on continuous ambulatory peritoneal dialysis CAPD treatment.

Specimens of the peritoneal dialysis fluid from patients on CAPD treatment with peritonitis manifestations were submitted for mycological studies and Acremonium spp. Because reported cases strictumm limited, optimal treatment of Acremonium species infections is not well-defined.

In addition, conflicting results have been obtained in different studies 3—5 Early catheter removal and prophylaxis have been suggested for peritoneal dialysis patients with fungal peritonitis The cure rate with fluconazole therapy alone without catheter removal was 9.

They concluded that oral fluconazole can be safely used as initial therapy in patients with fungal peritonitis complicating CAPD. General resistance to most antifungals, excluding amphotericin B and ketoconazole has been reported 5. Hence, amphotericin B therapy, in combination with ketoconazole or another acremoniim azole or allylamine, is advocated for Acremonium infections 3—516 Although Acremonium infection is rare in humans, cases have been increased recently. This is due to recent advances in medical technology that have led to increased numbers of immunosuppressed patients, receiving broad-spectrum antibiotics or having indwelling medical devices We emphasize the importance of an active search for unusual organisms like Acremonium strictum in immunodeficient patients and early specific treatment against such microoganisms for the reduction of their morbidity and mortality.


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Close mobile search navigation Article navigation. A case of Acremonium strictum peritonitis Asli Gamze Sener. Abstract During the past two decades opportunistic fungal infections have emerged as important causes of morbidity and mortality in patients with severe underlying illnesses. Acremonium strictumopportunistic fungal infectionperitonitis. View large Download slide.

Microscopic appearance of Acremonium strictum colorless. Andolent Acremonium strictum infection in an immunocompetent patient. Infection due to the fungus Acremonium Cephalosporium. Fatal disseminated Acremonium strictum infection in a preterm newborn: Disseminated Ochroconis gallopavum infection in a renal transplant recipient: Acremonium pyomyositis in a pediatric patient with acute leukemia.

Acremonium strictum – Wikipedia

Fatal disseminated Acremonium strictum infection in a neutropenic host. Lethal double infection scremonium Acremonium strictum and Aspergillus fumigatus during srtictum chemotherapy in a child with ALL.

Fungal peritonitis in 15 patients on continuous ambulatory peritoneal dialysis CAPD. Peritonitis due to Acremonium strictum in a patient on continuous ambulatory peritoneal dialysis. Treatment of fungal peritonitis complicating continuous ambulatory peritoneal dialysis with oral fluconazole: Acremonium strictum fungaemia in a paediatric patient with acute leukaemia. Invasive Acremonium falciforme infection in a patient with severe combined immunodeficiency.

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