Urinary tract aspergillosis in a patient with chronic kidney disease

Zhou, Linghong; Zhao, Hua-Zhen; Chen, Zhongqing; Zhu, Liping

doi:10.1136/bcr-2017-221638

Cited by 6 publications

(11 citation statements)

References 15 publications

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“…In a case report by El Saleeby et al, Aspergillus terreus was reported in a case of CKD similar to case 1 (5). Aspergillus infections of the urogenital tract are very rare (6). In case 1, A. terreus was reported in a case of CKD with scrotal swelling who is immunocompromised having diabetes.…”

Section: Design: Retrospective Case Seriesmentioning

confidence: 88%

A case series on pulmonary and tissue aspergillosis

Lokesh¹,

Prabha²,

S.Pramodhini³

et al. 2021

Biomedicine

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Aspergilli species cause opportunistic fungal infection in immunocompromised individuals. Invasive aspergillosis is a highly fatal opportunistic infection that accounts for amajor risk to immunocompromised patients. Among these species, A.fumigatus is the main opportunistic pathogen followed by A.niger and A.flavus. In immunocompetent individuals, the effective innate immunity eliminates theinhaled conidia and Allergic bronchopulmonary aspergillosis and aspergilloma are the only infections noted in them. Thus,A.fumigatus was considered for years to beainfirm pathogen. With increase in the number of immunosuppressed patients, however, there has been a marked increase in fatal invasive aspergillosis, which is now the widespread mold infection. In this case series, we have described four cases of aspergillosis. Male preponderance is seen, commonly seen in 4th to 5th decade, 3 out of 4 cases are immunocompromised having diabetes, chronic kidney disease, past history of tuberculosis and only one case was not associated with any comorbid illness. In case 4, the recurrence of polypoidalsinosis itself could be a risk factor causing erosion of nasal mucosa and chronic secretion.The morphological features of intraluminal lesions were of prognostic value. Most of the Aspergillosis patients had a good prognosis with early diagnosis and effective antifungal therapy.It can bedeadly if not diagnosed and treated properly.Very rarely aspergillosis may occur in immunocompetent individuals, which urged us to point outthese cases. With studies suggesting surging incidence and mortality rates, early diagnosis and treatment are paramount to upgrade patient survival.

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Section: Design: Retrospective Case Seriesmentioning

confidence: 88%

A case series on pulmonary and tissue aspergillosis

Lokesh¹,

Prabha²,

S.Pramodhini³

et al. 2021

Biomedicine

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“…55 Aspergillus spp., a common airborne mold that accounts for up to 40% of fungal contamination, has also reported as a cause of UTIs. [49][50][51] Nevertheless, aspergillosis limited to the urinary tract is an uncommon invasive aspergillosis type, which most often affects the lungs. 49 Pathological renal disease caused by Aspergillus infection has as characteristic multiple micro-abscesses, which indicate a hematogenous spread to the kidney.…”

Section: Fungal Infectionsmentioning

confidence: 99%

“…[49][50][51] Nevertheless, aspergillosis limited to the urinary tract is an uncommon invasive aspergillosis type, which most often affects the lungs. 49 Pathological renal disease caused by Aspergillus infection has as characteristic multiple micro-abscesses, which indicate a hematogenous spread to the kidney. 50 Moreover, it has been reported as a causative of the ureteric fungal ball leading to obstructive uropathy in leukemia and renal allograft patients.…”

Section: Fungal Infectionsmentioning

confidence: 99%

“…50,51 There are three major transmission routes, including ascending infections (usually from indwelling bladder catheters), trauma or surgical interventions, and hematogenous spread (common in immunocompromised patients). 49 According to the authors, a high level of suspicion is required in immunocompromised patients, particularly when hypoechoic mass is noted on ultrasonography 51 and when the patients are presenting with flocculi in urine, thus direct microscopy or culture of floccules in urine could be helpful. 49 Taking into account that this entity is rare, data on the most effective treatment modality continue being limited.…”

Section: Fungal Infectionsmentioning

confidence: 99%

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Atypical pathogens in urinary tract infections: a systematic review

Lima¹,

Gonçalves²,

Amorim³

et al. 2022

JMEN

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Urinary tract infection [UTI] accounts for a significant portion of the worldwide infections, whose cause occurs predominantly through Gram-negative bacilli, followed by Gram-positive bacteria and fungi. However, a number of cases by atypical pathogens are increasing. Thus, a systematic review was carried out on UTIs caused by atypical/emerging agents, covering etiological, epidemiological, clinical and therapeutic aspects. The search conducted via PubMed database and 59 articles composed the final sample. The laboratory approaches reported have included uroculture with special media; molecular methods such as PCR, real-time PCR, and nucleic acid sequencing; and MALDI-TOF mass spectrometry. Pathogens found among bacteria, including Gram-negative bacilli, Gram-positive cocci, diphtheroids, Mycoplasmataceae members, actinomycetes, and Gram-variable coccobacilli; yeasts, molds and microsporidia; virus, including BK polyomavirus, HPV, CMV and HSV-2; and a protozoan, Trichomonas vaginalis. The risk factors appear to be associated with patients' intrinsic features, such as advanced age, female gender, chronic diseases, prostatic hyperplasia, immunocompromised, genitourinary tract alteration; or risky situations as long-term urinary catheter usage, urinary tract manipulation, cancer chemotherapy, alcoholism, prolonged use of antibiotics and risky sexual behavior. The difficulty in identifying these agents was also evident, due to their peculiar characteristics or the unavailability of more sophisticated methods in the laboratorial routines, which implicates in the clinical management. Therefore, it is important that the medical and the microbiology teams are aware of the possibility of these agents in order to assess the need for further testing. The importance of antimicrobial susceptibility tests is also emphasized because of these organisms’ different profiles.

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“…Localized aspergillosis of the renal graft was reported in a child 5 months after kidney transplantation [61]. A case of urinary tract aspergillosis presenting as an aspergilloma of the urinary bladder has also been described [66].…”

Section: Aspergillosis Of the Genitourinary Tractmentioning

confidence: 99%

Invasive Aspergillosis in Transplant Recipients

Wróblewska¹,

Sulik-Tyszka²,

Figiel³

et al. 2020

Surgical Recovery

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Patients with hematological malignancies and recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT) as well as solid organ transplant recipients are the groups of patients with the highest risk of invasive fungal infections (IFI). Neutropenia, lymphopenia, chemotherapy of malignancies, radiation therapy, immunosuppressive therapy, administration of glucocorticosteroids, use of central venous catheters, dialysis therapy, liver and kidney failure, and diabetes are diseases and medical conditions which foster invasive fungal infections. In recent years, it has been observed that the most common etiological agents of these infections are yeastlike fungi of the genus Candida, and the second most common is moulds Aspergillus spp. Antifungal agent recommended for therapy of IFI caused by Aspergillus is voriconazole, according to the present guidelines. A combined therapy using voriconazole and caspofungin may not be effective. According to numerous publications, in case of infections caused by strains resistant to voriconazole, a therapeutic success is possible after a switch to the liposomal form of amphotericin B. Due to nonspecific clinical symptoms of IFI caused by Aspergillus spp., histopathological as well as mycological and serological tests, echocardiographic examination, magnetic resonance imaging (MRI) and computer tomography (CT) may contribute to an early and reliable diagnosis of invasive aspergillosis.

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Urinary tract aspergillosis in a patient with chronic kidney disease

Cited by 6 publications

References 15 publications

A case series on pulmonary and tissue aspergillosis

A case series on pulmonary and tissue aspergillosis

Atypical pathogens in urinary tract infections: a systematic review

Invasive Aspergillosis in Transplant Recipients

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