Localized primary renal aspergillosis in a diabetic patient following lithotripsy – a case report

<p>Abstract</p> <p>Background</p> <p>Primary renal aspergillosis is rare in diabetic patients. Diagnosis of localized primary renal <it>Aspergillus </it>infection in diabetic patients requires careful investigations due to its benign presentation and lack of associated systemic clinical features. There is also paucity of information on the role of conservative treatment of such localized infection with antifungal agents only. Here, we describe a case of localized renal aspergillosis in a type 2 diabetic patient with a brief review of literature.</p> <p>Case presentation</p> <p>We describe a case of unilateral renal aspergillosis following intracorporeal pneumatic lithotripsy (ICPL) in a type 2 diabetic man. The patient presented with mild pain in the left lumbar region and periodic expulsion of whitish soft masses per urethra, which yielded growth of <it>Aspergillus fumigatus</it>. He was treated initially with amphotericin B; however, it was stopped after 2 weeks, as he could not tolerate the drug. Subsequently, he was successfully treated with oral itraconazole.</p> <p>Conclusion</p> <p>Localized renal aspergillosis may be suspected in diabetic patients having history of urinary tract instrumentation, mild lumbar pain, passage of suspicious masses in urine and persistent pyuria. Examination of the suspicious substances expelled per urethra is essential for diagnosis as routine multiple urine analysis may yield negative results. Conservative treatment with oral itraconazole alone is effective in cases with incomplete obstruction.</p

Role of fine needle aspiration cytology in the diagnosis of palpable thyroid lesions

Fine needle aspiration cytology is now recommended as the first choice for the evaluation of palpable thyroid nodules. A total of 170 fine needle aspirates of thyroid were evaluated in which the subsequent biopsy were also available for histopathological examination. The age ranged from 16 to 70 years. The cytological diagnosis were compared with the histological results which revealed the sensitivity of 61.90% and 80.95%, the specificity of 99.31% and 76.55%, positive predictive value of 92.86% and 33.33%, negative predictive value of 94.74% and 96.52% and accuracy index of 94.58% and 77.11% were found, when considering suspicious cases alternatively as positives and negatives. Similar statistics from other series of studies revealed almost same results in which cytological results of thyroid lesions were compared with histological results. This suggests that FNAC is an effective and accurate technique for the diagnosis and further management of palpable thyroid nodules