Aspergillus 'fungus ball' within a cadaveric renal transplant graft.

Filamentous fungal infections are associated with a high morbidity and mortality in solid organ transplants. Species of the Aspergillus family account for the majority of these infections, and Aspergillus fumigatus, in particular, may be regarded as the most important airborne saprophytic fungus [1,2]. There are numerous conidia of this fungus inhaled constantly by humans, which are normally eliminated in immunocompetent hosts by innate mechanisms. An aspergilloma or allergic bronchopulmonary aspergillosis are the only infections observed in such hosts. Thus, Aspergillus was regarded as a weak pathogen for many years until there were an increased number of immunosuppressed patients, resulting in a dramatic rise in severe and frequently fatal invasive aspergillosis. The majority of solid organ transplant recipients with Aspergillus infection have pulmonary [3], rhino-cerebral or disseminated infection. Renal aspergillosis has rarely been reported [4]. The term ‘fungus ball’ refers to a saprophytic colonization of a cavity by fungal hyphae, without the invasion of the adjacent tissue. We report an isolated unusual case of an aspergilloma present within a cadaveric renal transplant graft in the absence of systemic infection.