Bergami G, Di Mario M, Barbuti D, Cozza R
Servizio di Radiologia, Ospedale Pediatrico Bambino Gesù, Roma.
Minerva Pediatr. 1991 May;43(5):389-92.
Candida albicans infections are opportunistic and range from asymptomatic infections to life-threatening involvement, with a wide spectrum of clinical manifestations. Urinary tract involvement is usually secondary to systemic infection, although the kidney or the bladder may be primarily infected without other organs being involved. Renal fungus infections, most commonly due to Candida, are usually seen in patients with altered host resistance due to diabetes, malignancy, other chronic illnesses, or prolonged antibiotic, corticosteroid or immunosuppressive therapy. Herein we report on an immunosuppressed 12 years-old girl with Candida albicans cystitis diagnosed with US. Sonography demonstrated a discrete dense fluid-fluid interface within the bladder, mobile with changes in position. US was used to monitor the progress of therapy. Treatment is usually conservative, related to removing the precipitating factors (catheters, antibiotics, steroids). Indeed, in our case, the immunosuppressed patient needed aggressive therapy: i.v. fluconazole. Sonography 15 days after treatment showed a normal bladder, without significant sequelae or the formation of vesical concretions.
白色念珠菌感染属于机会性感染，临床表现多样，从无症状感染到危及生命的感染均有。泌尿系统感染通常继发于全身感染，不过肾脏或膀胱也可能原发感染而无其他器官受累。肾脏真菌感染最常见的病因是念珠菌，多见于因糖尿病、恶性肿瘤、其他慢性疾病或长期使用抗生素、皮质类固醇或免疫抑制疗法导致宿主抵抗力改变的患者。在此，我们报告一名12岁免疫抑制女童，经超声诊断为白色念珠菌膀胱炎。超声显示膀胱内有一个离散的致密液 - 液界面，随体位改变而移动。超声用于监测治疗进展。治疗通常较为保守，主要是去除诱发因素（导管、抗生素、类固醇）。实际上，在我们的病例中，这位免疫抑制患者需要积极治疗：静脉注射氟康唑。治疗15天后的超声检查显示膀胱正常，无明显后遗症或膀胱结石形成。
