Possible role of erythropoietin in the pathogenesis of chronic cor pulmonale

grew Aspergillus flavus. Acute fungal prostatitis was diag-nosed, and treatment with itraconazole (200mg i.v. od) wasinitiated. Subsequently he developed a perinephric collection,which on drainage grew Escherichia coli and Aspergillus. Theantimicrobial regime was changed to vancomycin (1g i.v. bd)and imipenem (1g i.v. qds). The itraconazole was empiricallychanged to voraconazole (400mg i.v. od) and caspofungin(50mg i.v. od). The patient’s pyrexia and symptoms took afurther 8 weeks to resolve. He received voraconazole for atotal of 75 days (28days i.v. and 47 days orally) andcaspofungin for 23 days.Six months following discharge, the patient presentedagain with similar symptoms, reduced urinary flow and raisedinflammatory markers. A further TRUS of his prostatedemonstrated a cystic area involving the left seminal vesicle.He restarted anti-aspergillus treatment of voraconazole andcapsofungin. The patient’s obstructive urinary symptomsworsened and he underwent transurethral de-roofing of aprostatic abscess. The patient continued to improve and wasdischarged 3 weeks after the transurethral resection. He con-tinues on long-term voraconazole and is currently well with acreatinine of 138mmol/l, at 24 months post-renal transplant.