The first clinical case of disease produced by the Penicillium fungus ( no species specified) in the country was detected after noting color changes in the dialysis effluent of a child patient, affected with congenital nephrotic syndrome, according to a Medicina y Salud Publica report.
The patient who had her kidneys removed at the age of 5, arrived at the emergency room of the Hospital Universitario Pediátrico del Centro Médico de Puerto Rico when her mother noticed the color change while the girl underwent peritoneal dialysis on her home.
The mother noticed that the liquid she was dialyzing with was darker than normal. She brings her to the dialysis clinic, they take a culture and send her to her house, after a dose of intraperitoneal antibiotics. Two days later they call her from the hospital because the results show fungus and peritonitis is very common in patients who are dialyzed peritoneally, but it is more common for it to be due to bacteria.
Initially, the doctors indicated that it was a case of infection by Candida, since it is common in the appearance of peritonitis associated with dialysis. However, the results of laboratory tests report that it was an infection caused by Penicillium. Contracting this fungus is an unusual situation for medicine.
Fortunately, the minor did not develop complications because intervention could be done immediately, thanks to the timely action of the mother, since parents of patients with congenital nephrotic syndrome receive instructions to learn to manage the symptoms and effects caused by the disease. In this case mentioned, the treatment -although it only lasted six weeks- was challenging for the doctors, since there is no treatment guide for Penicillium infections.
The patient is preparing for transplantation, so she received two weeks of EV amphotericin and four weeks of oral [itraconazole]. Before being discharged, the cultures were negative, but she was discharged with three weeks of treatment and finished the others at home. . Currently the patient’s condition is stable.
The curious thing about this clinical case is that the minor was exposed, two days before noticing her color change, during a visit to a petting zoo, so they conclude that she may have acquired the fungus from some animal.
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