Case report: bilateral ureteral obstruction secondary to Aspergillus bezoar

Ureteral obstruction as a result of a primary aspergillus infection is rare. Early clinical suspicion in immunosuppressed patients is essential to diagnosis. We report a case of a 50-year-old diabetic woman presenting with acute renal failure, sepsis, and bilateral ureteral obstruction. Initial management included bilateral percutaneous nephrostomy tubes. Urine culture from both the left and right renal pelvis grew Aspergillus flavus. The left-sided obstruction resolved with antifungal therapy. However, her right ureteral obstruction persisted and was managed with ureteroscopy and removal of the fungal bezoar.