Along came a spider: an unusual organism identified in a peritoneal dialysis patient, a case report.

This review looks at how a 20-year-old male grew Rhodotorula muciliginosa (fungal infection) from his peritoneal dialysis fluid on three separate occasions. Peritoneal dialysis-associated peritonitis can uncommonly be caused by fungal infections. When they do present, they are associated with significant mortality and morbidity.

The study describes a case where a sample of peritoneal dialysate fluid grew Rhodotorula muciliginosa, a yeast organism present in the normal environment, which has previously been reported as rarely causing peritonitis. It is believed this is the first case where the Rhodotorula spp. and its origin has been identified.

The patient was not systemically unwell, and his peritoneal dialysate was clear. As Rhodotorula spp. is exceedingly difficult to treat; this patient had his Tenchkoff catheter removed.

Peritoneal dialysis (PD) is a type of dialysis which uses the peritoneum in a person's abdomen as the membrane through which fluid and dissolved substances are exchanged with the blood. It is used to remove excess fluid, correct electrolyte problems, and remove toxins in those with kidney failure

In order to find the cause subsequent samples of soil and sand from his bearded dragon and Chilean tarantula cases, kept in his bedroom where dialysis occurred, were tested. The tarantula sand was identified as the source of the Rhodotorula spp. Of note, Candida was isolated from sand from the bearded dragon case. Once his catheter was removed he was treated with an intravenous course of antifungal therapy. He has since had a new catheter inserted and education around pets and hygiene.

In this era where people are keeping increasingly rare and unusual wildlife in their homes, this case highlights the need for clinician and nursing staff awareness of a patient's home environment and hobbies when they are undergoing peritoneal dialysis or any invasive treatment. Sand from the patient's tarantula case grew the colonising organism but interestingly soil from his bearded dragon case also isolated candida.