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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
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Xanthogranulomatous pyelonephritis due to Aspergillus in a non-diabetic older patient

Neha Khilar1, Navneet Gupta1, Prabha Adhikari2

  • 1Internal Medicine, Yenepoya Medical College Hospital, Mangalore, Karnataka, India.

BMJ Case Reports
|September 17, 2021
PubMed

Insights

This case study highlights a rare instance of primary renal aspergillosis and xanthogranulomatous pyelonephritis in an immunocompetent older adult. Treatment involved antifungal therapy and nephrectomy, leading to symptom resolution.

Area of Science:

  • Nephrology
  • Mycology
  • Infectious Diseases

Background:

  • Xanthogranulomatous pyelonephritis (XGP) is a rare, destructive inflammatory condition of the kidney.
  • Primary renal aspergillosis typically affects immunocompromised individuals.
  • Risk factors for XGP and renal aspergillosis are well-documented, usually involving compromised immune status.

Observation:

  • A unique case of an older adult (early 60s) presented with fever and left flank pain.
  • The patient was diagnosed with primary renal aspergillosis concurrently with xanthogranulomatous pyelonephritis.
  • Notably, the patient had no underlying immunocompromising conditions or other typical risk factors.

Findings:

  • The patient's symptoms of fever and flank pain resolved following treatment.
  • Treatment consisted of a prolonged course of antifungal medication (itraconazole) and a nephrectomy.
  • This case demonstrates fungal pyelonephritis and xanthogranulomatous changes in the absence of predisposing factors.

Implications:

  • This case expands the understanding of renal aspergillosis and XGP, suggesting they can occur in immunocompetent individuals.
  • It underscores the importance of considering these diagnoses even without typical risk factors.
  • Further research may be needed to elucidate the pathogenesis in immunocompetent hosts.
Keywords:
infectionsurinary tract infections

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