Fungal Eosinophilic Peritonitis Due to AL Ternaria in a Patient on Continuous Ambulatory Peritoneal Dialysis

We describe an unusual episode of fungal peritonitis, caused by an Alternaria species and associated with a persistent eosinophilia in peritoneal fluid and blood. Peritoneal and systemic eosinophilia, persisting long after catheter insertion and, associated with the signs of peritonitis, should arouse suspicion of a fungus infection. About 5% of episodes of peritonitis in patients on CAPD are due to yeast, mainly of the Candida species (I). On rare occasions, cases have been re ported of peritoneal infections in CAPD patients caused by various filamentous fungi (2 7). Peritoneal fluid eosinophilia in CAPD patients, a self-limited, benign condition, is a well described entity and usually occurs soon after catheter implantation (8–10). We present an episode of a fungal peritonitis, associated with a late, longstanding eosinophilia of peritoneal fluid and peripheral blood. The responsible organism was a dematiceous filamentous fungus identified as Alternaria alternata.