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February 1968

Fulminating Disseminated Aspergillosis Complicating Peritoneal Dialysis in Eclampsia

Author Affiliations

Dundee, Scotland

From the departments of pathology (Dr. Ross), medicine (Drs. Anderson and Stewart, and midwifery and gynecology (Dr. Macnaughton), University of Dundee (Scotland).

Arch Intern Med. 1968;121(2):183-188. doi:10.1001/archinte.1968.03640020071015

Disseminated aspergillosis was not reported before the advent of antibiotics. In a review of the world literature Tan et al1 found 22 cases occurring since 1939, and described a further one. Almost all these cases, and others reported subsequently2,3 had received antibiotics or steroids, or both, and most had an underlying debilitating illness; one patient had Cushing's syndrome.4

The present case is unusual in that the portal of entry seems to have been a peritoneal infection resulting from peritoneal dialysis.

Patient Summary  A primigravida, age 22, had a normal antenatal course, until Nov 8, 1965 (36th week), when her blood pressure (BP) was 130/80 mm Hg and the urine contained a trace of protein. The major clinical events, together with antibiotic, steroid, and dialysis treatment are summarized in Fig 1. On Nov 20 (38th week) at 4:30 pm nausea, vomiting, and intermittent epigastric pain developed. The pain

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