Invasive Ureteral Aspergillosis Causing an Abscess: A Report of a Rare Case

TL;DR

A rare case of invasive ureteral aspergillosis causing an abscess is reported in a 54-year-old man with diabetes and urosepsis.

Contribution

This paper presents a rare clinical case of ureteral aspergillosis with abscess formation, highlighting its unusual presentation and treatment.

Findings

Aspergillus fumigatus was identified in a ureteric abscess adherent to the duodenum.

The patient recovered well after surgical drainage and antifungal treatment.

Abstract

Aspergillosis is a vicious fungal infection that can develop in immunosuppressed patients. The presence of aspergillosis in the ureter or elsewhere in the genito-urinary tract is highly uncommon and rarely reported in the literature. Here, we present a 54-year-old gentleman, with uncontrolled diabetes, who presented with urosepsis. Right hydronephrosis and ureteric stricture with urinary extravasation were seen on imaging. Right percutaneous nephrostomy was done, with drainage and analysis of the pus revealing the growth of Aspergillus fumigatus species. On open exploration, a ureteric abscess cavity, which was adherent to the duodenum, was drained and uretero-ureterostomy along with feeding jejunostomy was performed. Histopathological examination and special staining confirmed the growth of aspergillosis. The patient was treated with antifungal agents and responded well with an uneventful post-operative recovery.

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