Primary renal aspergillosis and xanthogranulomatous pyelonephritis in an immuno-competent Toddler

Aspergillosis is primarily a pulmonary disease so that renal aspergillosis is usually secondary to hematogenous spread from lungs. Primary renal aspergillosis, though a rare entity, is still seen in immuno-compromised individuals. Renal aspergillosis may lead to formation of focal abscesses, fungal bezoars and may cause ureteric obstruction. Treatment involves stabilization of patient and removal of fungal bezoars along with administration of anti-fungal agents. This report describes the case of localized primary renal aspergillosis with fungal bezoar formation in 2 years old immuno-competent child who presented in sepsis and acute renal failure and was successfully managed by nephroscopic removal of fungal bezoar and intravenous voriconazole. The other kidney required nephrectomy for xanthogranulomatous pyelonephritis.