Refractory peritonitis is defined as failure of effluent clearance after five days of appropriate antibiotics in peritoneal dialysispatients. It is a reason for peritoneal dialysis failure. Although fungal and mycobacterial peritonitis are uncommon (approxi mately 15% of the cases), they are difficult to diagnose and treat. Herein, we report a case of peritonitis caused by two unusualpathogen, Candida guilliermondii and Mycobacterium avium complex, which probably reached the peritoneum via the vaginalroute, in a long-term peritoneal dialysis patient with malnutrition. Rare organisms should be considered as causative agents inrefractory peritonitis cases.