My husband has been on PD dialysis for 14 months. We are following a rigid plan for cleanliness. Bleach and antibacterial soap are used religiously. Somehow, he has contracted Candida Parapsilosis. We are puzzled as to how this could have happened.
He has seen an Infectious Disease specialist who wants to wait to remove the port until antibiotic is completed and dialysis fluid is tested a week later. She said she may buy us some time up to a year.
We understend that the port will be removed and he will be put on hemo-dialysis until fungus infection is cleared, and then another port will be put in.
We have used Gentamicen cream at the port site daily. We have been advised to stop since it may be feeding the fungus.
Since we have no clue as to how my husband acquired the fungus, we are reluctant to have another port put in, fearing the same thing could happen again. Any advice would be appreciated.
Monday he will complete a 21 day perscription of Fluconazole 200 mg daily. The site looks great , no pain, dialysis solution is crystal clear,
He has had three times when a very small amount of pus came from exit site. There was barely enough for PD nurse to take a culture.
Has anyone else experienced this problem?
Hello, I’m a PD nurse, but it isn’t clear to me if the Candida parapsilosis caused an exit site infection or peritonitis episode.
Candida species are yeasts that are normal flora (but not the predominate flora) of the mucous membranes in the respiratory, gastrointestincal and female genital tracts.
The following would increase your risk of contracting an infection with a Candida species: diabetes, immunosuppression, dialysis catheter, general poor health, antibiotic therapy, and corticosteroids (e.g. prednisone).
Candidal exit site infections are difficult to cure, but sometimes do resolve. If there has been pus from the exit site recently, towards the end for the fluconazole treatment, this would indicate that the therapy is suppressing an infection at the exit or in the tunnel, but not eradicating it. If there have been no signs of exit or tunnel infection for some time, there is a chance it may have resolved.
On the other hand, intermittent purulent drainage from the exit site can be a sign of a catheter cuff infection. Once the infection is in the cuff material, it is impossible to completely get rid of it, because there is no blood supply within the cuff, so antibiotics can’t get there.
A yeast peritonitis is difficult to cure. We have seen the yeast actually imbedded in the catheter material. If you had a peritonitis, and it comes back again, you need to have the catheter removed immediately.
It sounds like your physicians have treated this appropriately. If you only had an exit site infection and it recurs soon, it’s still a good idea to go ahead and have the catheter removed before you get a Candida peritonitis.
Thank-you for your welcomed information. My husband does not have peritonitis. We are keeping a close watch on the drain fluid. It will be one week Monday since he stopped the antibiotic. There has been no more pus from the exit site. He has no pain , nor is he running a fever. We are in hopes it has cleared but realize this may not be possible. Thank-you again for your response. Ruth
We have discovered with my diabetic elderly father that if and when he “does sugar,” it can promote some sort of Candida infestation both in his gut and in his peritoneum. We have found a natural substance that explodes the organism, in essence, by dissolving the cell membrane, thus avoiding the “die-off reaction” that can produce toxins. The substance is cellulase and hemi-cellulase, which grazing animals possess but humans do not. The product is fairly inexpensive and is called Candex and is available OTC at health food stores or online.
Sometimes we get cloudy bags with no apparent infection and if we suspect Candida and use the Candex, the bags (and his diarrhea from feeding sugar to the yeast in his GI tract) clear right up. The Candida causes the body to produce fibrin, which accounts for the cloudiness as with bacteria, and we also use heparin in the bags to clear that up, as well.
If you study Candida health effects online, you’ll find it helps mediate a lot of chronic diseases, interestingly. The high-sugar modern industrialized diet fosters chronic Candida infestation, and it especially flourishes in the diabetic population. There is a body of evidence implicating Candida in the development of Type 1 diabetes in the very young as an aftermath of antibiotic use for ear infections, and Dan Dunphy of San Francisco Preventive Medical Group has reversed some cases using that knowledge.
You should also know that antibacterial preparations foster yeasts and fungi due to an overgrowth that happens because the bacterial population have been knocked down and the yeast or fungus infestation is opportunistically assisted thereby. One of our family members has to assiduously avoid antibacterial soap because it fosters a fungus on his knuckles that causes keratosis where the fungus sets up shop and then causes splitting and bleeding of the skin.