念珠感染的腹膜炎是腹透析時可能引起的嚴重併發症。接受腹透析的病患感染Candida sake引起的腹膜炎相當相罕,很少有文獻報導病的治療。另一方面,念珠感染通常採用單一藥物治療,在特殊況下才使用多種藥物合併的療法,而且,多種藥物合併的療法使用於小兒病患的經驗很少,尤其是嬰兒更是缺乏安全性及療效的報告。
在此,我們報告一位接受腹膜透析的女嬰,感染Candida sake引的腹膜炎,使用多種藥物的合併療法後治癒,包括caspofungin,flucytosine,微脂粒劑型amphotericn B和fluconazole,治療後病患沒有發燒,C-反應蛋白值下降,白血球維持在正常值,最後,黴菌根除。在不栘除析導管之下,使用含fluconazole之透析液與透析液交替腹膜透析的方式,對Candida sake引的腹膜炎效果不佳,嬰兒caspofungin 2.5 mg/kg/day耐受性良好,以及抗黴菌藥合併療法能成功治嬰兒腹膜透析引之Candida sake腹膜炎。

Fungal  peritonitis  is  a  serious  complication of  continuous  peritoneal  dialysis.  Candida  sake infection in patients undergoing peritoneal dialysis is very rare, and few reports mentioned about its management. In the other hand, combination therapy is needed only when traditional therapy failed or in some special situations and it has limited experience in pediatrics,   especially in neonates. This time, we described a neonate who had Candida sake-induced peritonitis during peritoneal dialysis and was cured by antifungal combination therapy. She received caspofungin, flucytosine, amphotericin B and fluconazole. Eight days after treatment, she was afebrile and her C-reactive protein(CRP) level was improving. Finally the fungal was eradicated.