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Journal of Case Reports
Successfully Treated Post-urosurgical Urinary Tract Aspergillosis
Neha Gupta1, Ashima Jain Vidyarthi2, Prasun Ghosh3, Dheeraj Gautam4, Kulbir Ahlawat5, Rajeev Soman6
Departments of 1Internal Medicine, 3Kidney & Urology, 4Histopathology, 5Radiology Medanta Hospital, Gurugram, Haryana, Delhi; 2Department of Microbiology, AIIMS, Delhi; 6Department of Infectious Diseases, Jupiter Hospital, Pune, Maharashtra, India.
Corresponding Author:
Dr Ashima Jain Vidyarthi
Email: drashima.aiims@gmail.com
Received: 04-FEB-2021 Accepted: 10-JUN-2021 Published Online: 05-JUL-2021
DOI: http://dx.doi.org/10.17659/01.2021.0037
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.
Keywords : Acute Kidney Injury, Antifungal Agents, Aspergillus flavus, Aspergillosis, Hydronephrosis.
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