Oliver Llinares F, Yáñez Angulo J M, Blanco Brunet J L
Sección de Urología Pediátrica, Hospital de Cruces, Baracaldo, Vizcaya.
Cir Pediatr. 1991 Oct;4(4):194-6.
Fungal urologic infections are unusual in children. They are associated with chronic uropathies, citostatics and antibiotic treatments and depressed immunity which allow the pathologic growth of a saprofitie organism. This infection must present special forms when the mycotic development is realized in cavities and special advantageous conditions. Then it adopt the form of fungal bezoars, and it can mobilize itself and provoke obstructions in the urinary tract. We present two cases of urinary obstructions secondary to fugal bezoars. The obstruction was localized in the uretero-vesical junction. In both of them the infection was associated with long antibiotic treatment, and with severe immunodeficiency only in one. The diagnosis was possible by echography and direct determination of candida albicans in urine. We proved also temporary ureterovesical stenosis we found before a reflux. The treatment included intravenous and local anfotericine B with dissolution of the bezoar in three and four days respectively.
真菌性泌尿系统感染在儿童中并不常见。它们与慢性尿路疾病、细胞抑制剂和抗生素治疗以及免疫力低下有关，这些因素使得腐生菌得以病理性生长。当真菌在腔隙中生长并处于特殊有利条件时，这种感染会呈现出特殊形式。然后它会形成真菌粪石的形式，并且能够自行移动并引发尿路梗阻。我们报告两例继发于真菌粪石的尿路梗阻病例。梗阻位于输尿管膀胱连接处。在这两例病例中，感染均与长期抗生素治疗有关，仅其中一例伴有严重免疫缺陷。通过超声检查和直接检测尿液中的白色念珠菌得以确诊。我们还证实了在出现反流之前发现的暂时性输尿管膀胱狭窄。治疗包括静脉注射和局部使用两性霉素B，粪石分别在三天和四天内溶解。
