Yonsei Med J.  2011 Sep;52(5):866-868. 10.3349/ymj.2011.52.5.866.

Invasive Aspergillosis Arising from Ureteral Aspergilloma

• Choi H
• Kang IS
• Kim HS
• Lee YH
• Seo IY

• KMID: 1108084
• DOI: http://doi.org/10.3349/ymj.2011.52.5.866

Abstract

Ureteral obstruction may develop in immunocompromised patients with an Aspergillus fungal infection. Infections can progress to invasive aspergillosis, which is highly lethal. We report a case of a 56-year-old man with alcoholic cirrhosis of the liver and diabetes. He had ureteral aspergilloma, discovered as a saprophytic whitish mass. It was treated by ureteroscopic removal, however, he refused antifungal treatment. His condition progressed to invasive aspergillosis, and died from sepsis and hepatorenal syndrome.

Keyword

Aspergillosis; ureteral obstruction; immunocompromised patient

MeSH Terms

Aspergillosis/diagnosis/*etiology
Diabetes Complications
Fatal Outcome
Humans
Immunocompromised Host
Liver Cirrhosis, Alcoholic/complications
Male
Middle Aged
Ureteral Diseases/diagnosis/*etiology
Ureteral Obstruction/diagnosis/etiology

Figure

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  Fig. 1 Ureteroscopic findings show a whitish mass in the upper ureter beside a guide wire edematous ureteral orifice.

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  Fig. 2 A histologic section of the specimen shows fruiting bodies and septate filaments, 5 to 10 µm thick, branching at acute angles (H&E stain, ×400).

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  Fig. 3 A follow-up CT image shows an infarcted right kidney with multifocal necrotic low attenuated lesions (arrow) in the renal parenchyma. CT, computed tomography.

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