Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Republic of Korea.
Med Mycol. 2010 Jun;48(4):647-52. doi: 10.3109/13693780903403035.
Urinary tract obstructions caused by Aspergillus bezoars has been reported on rare occasions. We describe in this paper an unusual case caused by an isolate of the Aspergillus nidulantes subgenus, and review the literature on 13 additional cases of ureteral obstruction due to renoureteric aspergillosis so as to provide the characteristics of this disease entity. Our case presented with a unilateral ureteral obstruction and acute renal failure due to Aspergillus bezoars. The patient was immunocompromised having received corticosteroid therapy for chronic obstructive lung disease and bronchiectasis. She was treated successfully with antifungal chemotherapy, including amphotericin B followed by oral voriconazole for about two months and had a percutaneous nephrostomy for one month. The patient's renal function completely recovered after hemodialysis maintenance for six months.
曲霉菌胃石导致的尿路梗阻罕见报道。本文报道了一例由构巢曲霉亚种引起的不常见病例,并对 13 例因肾输尿管曲霉菌病导致输尿管梗阻的病例进行了文献回顾,以提供该病的特征。本例表现为单侧输尿管梗阻和曲霉菌胃石导致的急性肾衰竭。患者因慢性阻塞性肺病和支气管扩张症接受皮质类固醇治疗而免疫功能低下。给予两性霉素 B 联合口服伏立康唑抗真菌化疗约 2 个月,行经皮肾造瘘术 1 个月后,患者成功治愈。经过 6 个月的血液透析维持治疗后,患者肾功能完全恢复。