Bilateral Renal Aspergillosis

Warshawsky, Arthur; Keiller, Danny L.; Gittes, Ruben F.

doi:10.1016/s0022-5347(17)59393-3

Cited by 35 publications

(5 citation statements)

References 17 publications

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“…Aspergillosis was the second commonest mycotic infection of the kidney and was usually seen as part of a blood-borne dissemination (Warshawsky, Keiller & Gittes 1975). Isolated renal infection is rare (Flechner & McAninch 1981).…”

Section: Discussionmentioning

confidence: 99%

Fungal and nocardial infections of the kidney

Raghavan¹,

Date²,

Bhaktaviziam³

1987

Histopathology

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This report describes 16 cases of candidiasis, seven of aspergillosis, four of mucormycosis, two of cryptococcosis and one of nocardiosis in which the kidney was involved. Characteristic patterns of renal tissue injury were seen in each of these infections. Candida and nocardia caused microabscesses in the cortex and medulla. Tissue destruction was minimal with candidiasis and when present was confined to the papillary tips and produced only mild impairment of renal function. Aspergillus and mucor invaded blood vessels resulting in thrombosis and extensive necrosis of cortical and medullary tissue and most patients had clinical and biochemical evidence of renal disease. Cryptococcosis caused no tissue reaction or clinically evident renal disease in the two immunosuppressed patients studied.

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Section: Discussionmentioning

confidence: 99%

Fungal and nocardial infections of the kidney

Raghavan¹,

Date²,

Bhaktaviziam³

1987

Histopathology

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“…Each publication reported clinical improvement with the combination therapy; then in 1975, the first triple-antifungal therapy was used with amphotericin B plus 5-fluorocytosine plus rifampin to treat a patient with renal aspergillosis, who also showed improvement [77].…”

Section: /Mic A] + [(Mic B In Combination)/mic B]mentioning

confidence: 99%

Combination and Sequential Antifungal Therapy for Invasive Aspergillosis: Review of Published In Vitro and In Vivo Interactions and 6281 Clinical Cases from 1966 to 2001

2003

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The development of newer antifungal drugs is creating new potential combination therapies to combat the dismal mortality rate associated with invasive aspergillosis (IA). The efficacy of combination therapy for IA has not been established; sparse data on combination or sequential antifungal therapy depict interactions ranging from synergy to antagonism. We reviewed data from all published in vitro studies, animal model studies, and clinical reports and recent abstracts on combination and sequential antifungal therapy for IA from 1966-2001. Among cases of IA during 1966-2001, 249 were treated with 23 different antifungal combinations. Amphotericin B plus 5-fluorocytosine was the most commonly used (49% of cases), followed by amphotericin B plus itraconazole (16%) or plus rifampin (11%). Combination therapy resulted in improvement in 63% of patients, generally with amphotericin B plus 5-fluorocytosine or rifampin and indifference with amphotericin B plus itraconazole. In 27 in vitro reports, we found synergy (in 36% of reports), additivity (in 24%), indifference (in 28%), and antagonism (in 11%). Amphotericin B plus 5-fluorocytosine and amphotericin B plus rifampin showed generally positive interactions and amphotericin B plus itraconazole showed results that were largely indifferent. Eighteen animal model reports demonstrated synergy (in 14% of reports), additivity (in 20%), indifference (in 51%), and antagonism (in 14%). In general, amphotericin B plus 5-fluorocytosine, amphotericin B plus rifampin, and amphotericin B plus itraconazole showed indifferent results, whereas amphotericin B plus micafungin showed positive interactions. Thirty-four cases treated during 1990-2001 with sequential therapy, excluding amphotericin B followed by itraconazole, showed improvement in 68% of cases. Improvement was noted with amphotericin B or itraconazole followed by voriconazole but not with itraconazole followed by amphotericin B.

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“…Patients with compromised immune status, such as diabetics, those on corticosteroid therapy and HIV positive individuals are more vulnerable to infection by Aspergillus species [1]. A few cases of renal aspergillosis have been reported in diabetics [2-6]. Here, we describe a case of localized renal aspergillosis following ICPL and ureteric stenting in a diabetic man.…”

Section: Introductionmentioning

confidence: 99%

Localized primary renal aspergillosis in a diabetic patient following lithotripsy – a case report

et al. 2007

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Background: Primary renal aspergillosis is rare in diabetic patients. Diagnosis of localized primary renal Aspergillus infection in diabetic patients requires careful investigations due to its benign presentation and lack of associated systemic clinical features. There is also paucity of information on the role of conservative treatment of such localized infection with antifungal agents only. Here, we describe a case of localized renal aspergillosis in a type 2 diabetic patient with a brief review of literature.

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Bilateral Renal Aspergillosis

Cited by 35 publications

References 17 publications

Fungal and nocardial infections of the kidney

Fungal and nocardial infections of the kidney

Combination and Sequential Antifungal Therapy for Invasive Aspergillosis: Review of Published In Vitro and In Vivo Interactions and 6281 Clinical Cases from 1966 to 2001

Localized primary renal aspergillosis in a diabetic patient following lithotripsy – a case report

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