Kueter Joseph C, MacDiarmid Scott A, Redman John F
Department of Urology, University of Arkansas College of Medicine, Little Rock, Arkansas 72205-7199, USA.
Urology. 2002 Apr;59(4):601. doi: 10.1016/s0090-4295(01)01666-1.
Mycelial clumps or bezoars (fungus balls) as a cause of upper urinary tract obstruction are rare, with fewer than 60 cases previously reported. Anuria due to bilateral ureteral obstruction with mycelial clumps is most rare. We report a man with bilateral ureteral obstruction by Aspergillus flavus and describe his diagnosis and treatment. It is remarkable that imaging modalities, including excretory urography, computed tomography, and retrograde ureteropyelography, did not identify filling defects to suggest a fungal causation of the ureteral obstruction, even in the presence of a rapidly progressing process. For this reason, one should consider a fungal infestation in high-risk patients with obstructive uropathy of unknown etiology.
菌丝团块或粪石（真菌球）作为上尿路梗阻的病因较为罕见，此前报道的病例不足60例。双侧输尿管被菌丝团块阻塞导致无尿极为罕见。我们报告一例由黄曲霉引起双侧输尿管梗阻的男性病例，并描述其诊断和治疗过程。值得注意的是，包括排泄性尿路造影、计算机断层扫描和逆行输尿管肾盂造影在内的影像学检查方法，即使在病情快速进展的情况下，也未发现充盈缺损以提示输尿管梗阻的真菌病因。因此，对于病因不明的梗阻性尿路病高危患者，应考虑真菌感染。
