Case report: Ulocladium spp. (mold) catheter-related peritoneal dialysis-associated peritonitis.

Peritoneal dialysis-associated peritonitis (PD peritonitis) is a serious complication of PD, with fungal cases carrying high morbidity and mortality. We report a 65-year-old female with PD peritonitis caused by Ulocladium, a filamentous fungus not previously implicated in the literature. She was asymptomatic at presentation but noticed black spots in her PD catheter lumen; effluent analysis confirmed peritonitis. Initial cultures grew nonspecific mold, prompting treatment initiation with intravenous liposomal amphotericin B and PD catheter removal. Final cultures identified Ulocladium spp., sensitive to amphotericin B, and treatment continued for four weeks. The patient successfully resumed PD after treatment. This case highlights the need for clinicians to maintain a high index of suspicion for fungal PD peritonitis in patients undergoing PD, and the importance of early initiation of systemic antifungals and prompt catheter removal to improve outcomes.