Primary renal aspergillosis: extremely uncommon presentation in patients treated with bone marrow transplantation

Invasive aspergillosis affects 3 to 11% of BMT patients with a high mortali ty rate (60 to 95%), Extra-pulmonary disease is an unusual event, and prima ry renal aspergillosis is extremely uncommon. A patient with CML treated wi th BMT, who developed primary renal and subsequently hepatic aspergillosis, is described, Dysfunction of the mucosal barrier secondary to conditioning therapy, was a possible portal of entry for the fungus. Fine needle aspira tion was very useful, as is direct microscopic examination of the urine, fo r diagnosis of the fungal infection. Surgical drainage of the abscess follo wed by antifungal therapy is the treatment of choice. Unconducive situation s, such as refractory thrombocytopenia, are associated with the worst outco me in these patients.