Renal transplantation
Complication
Urogenital system
An Unusual Cause of Ureteral Obstruction in a Renal Transplant Recipient: Ureteric Aspergilloma

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Abstract

Mycotic infections in various organ transplant recipients represent severe and often fatal complications. Aspergillosis isolated from the urinary tract occurs quite infrequently in renal transplant recipients. Besides, fungus balls are rare causes of ureteral obstruction. We report a 51-year-old patient with the diagnosis of ureteral obstruction caused by aspergillosis in the early post-renal transplant period, who unfortunately died with the clinical picture of disseminated infection and its complications.

Section snippets

Case report

A 51-year-old man underwent a live unrelated renal transplantation in August 2003 in India. Chronic glomerulonephritis of unknown etiology was the cause of his end-stage renal disease. The ureterovesical anastomosis was performed by Lich-Gregoir method; a double-J stent was inserted. The postoperative period was uneventful. The patient was discharged on the 7th day. He came to our center for posttransplant follow-up. He received immunosuppressive treatment with prednisolone, mycophenolate

Discussion

Aspergillus usually affects the lungs, central nervous system, sinuses, and skin.7 Urinary tract infections caused by Aspergillus species are uncommon and usually part of systemic hematogenous dissemination. Urinary tract aspergillosis usually presents as either renal or prostatic parenchymal disease or as an obstructing fungus ball.4 Anuria due to bilateral ureteral obstruction with Aspergillus flavus is most rare.8 Previously, this complication only has been reported in two renal transplant

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    Citation Excerpt :

    To our knowledge, only two reported renal transplant recipients with such complications [23,28]. One case was a relatively young patient who presented early after transplant and died of acute circulatory failure, ischemia, and disseminated infection [23]. The second case was a young patient who received a kidney from his mother and presented after 13 months of transplantation.

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