A case of Acremonium falciforme peritonitis in a 50-year-old man with a 10-year history of end stage renal disease that was on Continuous Ambulatory Peritoneal Dialysis for 8 years is reported. The aim of this report is to remind the clinician that in resistant and life-threatening peritonitis, A. falciforme may be the cause. This fungus was identified as A. falciforme in culture by its characteristic colonies and microscopic morphological findings. In vitro fluconazole and amphotericin B minimum inhibitory concentrations (MICs) were found as 6 and 0.125 µg/mL respectively. First fluconazole and then amphotericin B was administered, but patient was deceased on day 10 of amphotericin B therapy. This indicates that more antifungal susceptibility studies should be done before making a comment about in vivo and in vitro concordance of susceptibility of filamentous fungi.
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