Aspergillosis of the urinary tract: ascending route of infection and evolving patterns of disease.

Aspergillosis limited to the urinary tract is a rare disease, seen most often in patients with altered immunity, especially diabetics. The disease has 3 patterns, 2 of which have been described previously. We report the first case documenting the ascending route of infection. Multiple urine cultures may be required for proper identification. Histopathology and culture of sloughed tissue and fungus balls shed per urethram are the essential means of reliable diagnosis. successful treatment of this disease localized to the urinary tract require a high index of suspicion in certain clinical settings, prompt diagnosis, a combination of systemic and local antifungal chemotherapy, and surgical drainage when necessary.