A 45-year-old man from Nepal with a 13-year history of polycystic kidney disease was diagnosed as suffering from chronic renal failure with end-stage renal disease. After receiving empirical antituberculosis treatment, he was treated with broad-spectrum antibiotics. A left nephrectomy was performed, and after 4 months, he received a kidney transplant. The left kidney was grossly enlarged, with multiple cystic spaces filled with blackish material. Histologic examination of the excised left kidney tissue stained with hematoxylin and eosin and Gomori's methenamine silver stains showed numerous hyaline, septate, fungal hyphae of various lengths, many broken into rectangular arthroconidia in the cystic spaces. Culture of the kidney tissue yielded white, glabrous, yeast-like colonies. Based on its micromorphology, growth at 42°C, and ribosomal DNA (rDNA) sequence analysis, and also sequence analysis of the internal-transcribed-spacer and D1/D2 rDNA regions, the yeast was identified as Trichosporon loubieri. Postsurgically, the patient was treated with amphotericin B and oral itraconazole, followed by maintenance therapy with fluconazole. He remained afebrile and asymptomatic. At the final follow-up, all parameters were found normal and the patient was doing well, with normal renal function reports. This paper presents the first known case of human infection caused by T. loubieri.

Aspergillus peritonitis is a rare, potentially fatal complication of continuous ambulatory peritoneal dialysis (CAPD). We report a case of CAPD peritonitis caused by Aspergillus terreus in a 55-year-old female patient.

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Background: Health literacy is importantly recognized to combat the increasing incidence of kidney disease in the community and kidney health for all campaigns. Various kinds of digital platforms and tools are used to bridge the gap in health literacy to improve kidney health. Fifty percent of the world population is devoid of internet connection or poor connectivity. Digital library plays a vital role in digital literacy and this present study is done to see if sever specially designed can work without the internet with digital library software. Methods: A specially designed server that can connect with a digital device along with a regular internet-based server was loaded with digital library software. Devices with regular browsers were to access the server with the web address juxtaguide.com. Users included the admin who had full control over the device and other users were divided into teachers group I N = 25 for online and group II, N = 20 for offline study, and they were allowed to upload various format digital files for their students to access. Students in the study group were n = 250 online and n = 80 in an offline group. They were assessed if they can access the digital material, search and also participate in chat functions with their teachers. Links were shared through social media for online mode. Results: Teachers in both offline and online mode were able to access the server register and upload files in all formats like mp3, mp4, PDF, documents, links, blogs, and images, using digital device including laptops or mobile phones. Students were able to communicate in the offline mode similar to the online mode with various digital devices. The offline server was portable and could run on a backup inverter power source and could run continuously with a hot spot range of 50 meters. The upload and download speed for the offline version was not affected whereas in the online mode, when in 2G the internet was of low speed, bigger files were not downloadable. The maintenance cost of the offline server was minimal compared to the online server. Discussion: For the first time in the world, a server was converted to function in the offline mode, having the ability to synchronize with an online server that holds the same digital library software. All criteria of a digital library were full filled. In the offline mode, the device was also successful in two- way communication which no one could achieve to date. Conclusion: DigiNet as a digital library device fulfills all requirements to be a cost-effective device for offline literacy development. It also gives new hope to surpass not only the health literacy barrier but also opens huge potential for its use in future research and education. Further research is to be conducted with regards to the extension of its range up to 12 km.