Invasive Genitourinary Aspergillosis in a Patient with Chronic Lymphocytic Leukemia Treated with Venetoclax: Case Report and Review of the Literature

Albin, Owen; Soper, Nathaniel J.; Khurana, Irina; Kauffman, Carol A.

doi:10.1093/ofid/ofz457

Cited by 2 publications

(3 citation statements)

References 11 publications

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“…A few cases of primary renal aspergillosis have been described in patients with human immunodeficiency virus (HIV) infection, intravenous drug users (IVDU) [4], or renal transplantation. Recently primary GU IA has been described in a receiving venectoclax for treatment of chronic lymphocytic leukemia (CLL) [1]. Renal pelvis involvement can manifest as either bezoar and casts formation (aspergilloma or a fungus ball) or invasive aspergillosis with subsequent obstructive symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Invasive fungal infections (IFI) of the genitourinary tract are increasingly being recognized. This is perhaps due to expanding population of highrisk patients, use of novel pharmacotherapies and immunosuppressants [1], as well as due to increasing number of genitourinary procedures. This may also be attributed to the advances in the radiological and microbiological diagnostic methods.…”

Section: Introductionmentioning

confidence: 99%

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Successfully Treated Post-urosurgical Urinary tract Aspergillosis

Gupta¹,

Vidyarthi²,

Ghosh³

et al. 2021

JCR

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Successfully Treated Post-urosurgical Urinary tract Aspergillosis

Gupta¹,

Vidyarthi²,

Ghosh³

et al. 2021

JCR

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“…Some therapeutic agents are linked to unanticipated increases in opportunistic fungal infections to the genitourinary system. Primary genitourinary invasive aspergillosis was presented in a patient with chronic lymphocytic leukemia report (1). Also, some males have been diagnosed with concurrent prostatic and renal aspergillosis (2).…”

Section: Introductionmentioning

confidence: 99%

Pathological study of genitourinary invasion by Aspergillus flavus in male rats

Kadhim¹,

Faleh²

2021

IJVS

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Due to the widespread of A. flavus spores and the high risk of its mycotoxins in our environment, we investigated the pathological effects of A. flavus on genitourinary system in experimental rats using a whole sonicated antigen (WSA), and modified mycotoxin (mycotoxoid) in the immunization process. Fifty albino male rats were involved, subdivided into five group, each group of 10 male rats. Group one as a negative control received phosphate buffer saline, group two as a positive control received a challenge dose of 1×10 6 /0.5ml viable conidia/rat, while group three was immunized by a mixture of WSA and mycotoxoid, G4 was immunized by WSA alone, and G5 was immunized by mycotoxoid alone. The immunization was performed in two doses with 2 weeks interval. The results showed a high immune response (in group three G3) stimulated by the mixture (WSA and mycotoxoid), which revealed a significant increase in both IL-17 and IFN-γ. After experimental infection, the sero-analysis showed a significant increase in IL-17 and IFN-γ serum levels compared with the mixture-immunized group which showed no significant increases. In addition, the histopathologic sections illustrated severe chronic inflammation with a typical fungal granulomatous reaction in the prostate glands and kidneys compared with the WSA-immunized groups which showed mild histological reactions. Finally, we conclude that A. flavus is a serious opportunistic pathogen that can disseminate into genitourinary organs inducing severe pathologic lesions and even death. Moreover, we found that immunization by WSA and mycotoxoid can significantly reduce both immune and histopathological effects of A. flavus and its mycotoxins.

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Invasive Genitourinary Aspergillosis in a Patient with Chronic Lymphocytic Leukemia Treated with Venetoclax: Case Report and Review of the Literature

Cited by 2 publications

References 11 publications

Successfully Treated Post-urosurgical Urinary tract Aspergillosis

Successfully Treated Post-urosurgical Urinary tract Aspergillosis

Pathological study of genitourinary invasion by Aspergillus flavus in male rats

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