title: Beware! Fungal urosepsis may follow endoscopic intervention for prolonged indwelling ureteral stent.
abstract: We present a 38-year-old lady with a prolonged indwelling ureteral stent that had been placed for pain relief after development of Steinstrasse following extracorporeal lithotripsy for a 2.5-cm left renal calculus. The patient developed candidal urosepsis within 6 hours after ureteroscopy and percutaneous nephrolithotomy (PCNL) for the removal of residual fragments. She subsequently recovered on systemic antifungal therapy in the form of intravenous amphotericin B and achieved complete stone clearance after repeat ureteroscopy and PCNL. Fungal urosepsis is known to complicate the postoperative course in chronically debilitated patients with poor nutritional status or those with diabetes or other significant comorbities. To our knowledge, this is the first reported case of a patient with no significant comorbities developing fungal urosepsis after endoscopic intervention for a long-term indwelling ureteral stent.
authors.affiliation: Department of Urology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Gagan
authors.initials: G
authors.lastname: Gautam
authors.forename: A K
authors.initials: AK
authors.lastname: Singh
authors.forename: Rajeev
authors.initials: R
authors.lastname: Kumar
authors.forename: A K
authors.initials: AK
authors.lastname: Hemal
authors.forename: Atul
authors.initials: A
authors.lastname: Kothari
mesh_terms: D000328:Adult; D002176:Candida albicans / Q000472:pathogenicity; D002177:Candidiasis / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects* / Q000379:methods; D010146:Pain / Q000209:etiology; D059408:Pain Management; D018805:Sepsis / Q000209:etiology; D015607:Stents; D014514:Ureteral Calculi / Q000628:therapy; D014515:Ureteral Diseases / Q000209:etiology / Q000382:microbiology*; D018666:Ureteroscopy / Q000009:adverse effects* / Q000379:methods