Successfully Treated Post-urosurgical Urinary Tract Aspergillosis

[摘要] Background: Fungal infections of the genitourinary tract were a rare entity till now. However, with the marked rise in invasive genitourinary procedures and advances in radiological and microbiological diagnostics, such infections are increasingly being reported. Case Report: We report a case of 59-year-old gentleman who presented with fever, acute kidney injury due to left hydroureteronephrosis following a double-J (D-J) ureteral stent. Nephroscopic removal of slough material showed amorphous material along with numerous septate fungal hyphae. Cultures grew Aspergillus flavus. He was treated initially with voriconazole for 2 months. However, he had a relapse after 3 months which was managed with amphotericin deoxycholate (AmB-d) and 5-flucytosine (5-FC). The patient responded well subsequently and has been keeping well during the 5-year follow up period. Conclusion: Successful outcome for post-urosurgical urinary tract aspergillosis depends upon a combined surgical and medical approach with good effective source control and appropriate mold-active antifungal agents. Good infection control practices need to be adequately emphasized.

[学科分类] 生理学

[关键词] Acute Kidney Injury;Antifungal Agents;Aspergillus flavus;Aspergillosis;Hydronephrosis.