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A 38-year-old man presented with intermittent right flank pain, dysuria, passage of turbid urine and low-grade fever for the last 1 year. He revealed a history of right-sided laparoscopic Anderson-Hynes dismembered pyeloplasty with double J (DJ) stenting performed for right pelviureteric junction obstruction 5 years back at other centre. The discharge card given to the patient advised for DJ stent removal, but the patient was lost to follow-up and never underwent DJ removal. His medical history was unremarkable for diabetes, HIV or steroid intake. On physical examination there was tenderness present in right flank on deep palpation. Blood serum chemistries revealed mildly deranged renal function tests (blood urea nitrogen 56 mg/dL; serum creatinine 1.5 mg/dL) with normal random blood sugar (92 mg/dL) and liver function tests. Urine analysis showed 40–50 pus cells/high power field (HPF), 20 red blood cells/HPF and presence of fungal hyphae and spores. Urine culture revealed >105 …
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