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Bacterial infections of dialysis access fistulae are well known in patients with end-stage renal disease, but fungal infections of these prostheses have not been reported. Two patients who presented with recurrent infections and thromboses of their grafts grew Staphylococcus aureus and Cephalosporium species. This new entity suggests a different approach to the management of clotted grafts in patients with end-stage renal disease. If fungus is isolated from the graft, extirpation of the graft and amphotericin B therapy are suggested. We review here the mycology of Cephalosporium species, in-vitro sensitivity studies, and previous reports of infection with this fungus.