Bipolaris: a rare etiology of ureteric mycosis with Double J stent in situ

Fungi classified under the genera Bipolaris are dematiaceous hyphomycetes which are rare sources of human diseases. The dematiaceous fungi in other words "black fungi" are so named due to the presence of dark melanin like pigment in their cell wall. Majority of the species of Bipolaris, are either soil saprobes or plant pathogens, however few species of these saprobes like Bipolaris australiensis, Bipolaris hawaiiensis & Bipolaris spicifera are potential pathogens which are capable of causing infections in both immunocompetent & immunocompromised humans. The spectrum of human infections caused by Bipolaris include cutaneous and subcutaneous infections, allergic sinusitis, keratitis, allergic broncho pulmonary diseases, orbitopathy, CNS infections, Peritonitis associated with Ambulatory peritoneal dialysis, infections of implant devices & allografts. Here we report a case of ureteric infection due to Bipolaris species in a patient with Double J (DJ) stent in situ. Amphotericin B, itraconazole, voriconazole and imidazole are common antifungals found to be effective in treating Bipolaris infections.