Secondary peritonitis in a patient with cirrhosis involving Hyphopichia burtonii, an emerging fungal pathogen
Erica B. Feldman,
Amy L. Bellinghausen,
Irine E. Vodkin,
Shira R. Abeles,
Biren B. Kamdar
Affiliations
Erica B. Feldman
Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), 9500 Gilman Drive, Mail Code 7381, La Jolla, CA 92093, USA; Corresponding author.
Amy L. Bellinghausen
Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), 9500 Gilman Drive, Mail Code 7381, La Jolla, CA 92093, USA
Irine E. Vodkin
Division of Gastroenterology, Department of Medicine, University of California San Diego (UCSD), 9500 Gilman Drive, Mail Code 0063, La Jolla, CA 92093, USA
Shira R. Abeles
Division of Infectious Diseases & Global Public Health, Department of Medicine, University of California San Diego (UCSD), 9500 Gilman Drive, Mail Code 0507, La Jolla, CA 92093, USA
Biren B. Kamdar
Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), 9500 Gilman Drive, Mail Code 7381, La Jolla, CA 92093, USA
We present a case where Hyphopichia burtonii, a yeast, speciated from peritoneal fluid in a cirrhotic patient with secondary peritonitis. The patient, a man in his 60s with decompensated cirrhosis, was admitted for an upper gastrointestinal (GI) bleed. On admission, he was treated empirically for spontaneous bacterial peritonitis (SBP) but failed to improve with antibiotics. Serial paracenteses revealed polymicrobial peritonitis and rising peritoneal polymorphonuclear leukocytes (PMNs). These findings raised concerns for secondary peritonitis, prompting an abdominal computed tomography (CT) scan which revealed ischemic bowel. Among the peritoneal microbiota isolated, Hyphopichia burtonii predominated. Hyphopichia burtonii has only recently been reported as a human pathogen, previously it had only reported as a pathogen in bats[1,2].
