Pediatric Intensive Care Unit, Carlos Haya University Hospital, Malaga, Spain.
Pediatric Infectology Unit, Carlos Haya University Hospital, Malaga, Spain.
J Med Microbiol. 2010 Mar;59(Pt 3):367-369. doi: 10.1099/jmm.0.012799-0. Epub 2009 Nov 12.
Fungal infection of the kidneys is a rare condition that has been reported in premature babies and in diabetic or immunocompromised adult patients. Candida spp. is the most frequent micro-organism involved. This paper reports a case of an immunocompetent newborn with a bladder exstrophy who suffered from an acute renal failure caused by bilateral renal aspergilloma (Aspergillus flavus). The newborn was treated with amphotericin B urinary tract irrigation through bilateral nephrostomy catheters, combined with liposomal amphotericin B and voriconazole therapy, which improved his renal function. However, due to persistent fungal colonization, a long antifungal treatment and permanent ureterostomies were necessary to deal with new episodes of ureterorenal obstruction. As of November 2009, despite the renal injuries, renal function had been conserved. The management of the mechanical obstruction and the choice of antifungal drugs are discussed in this unusual case.
肾脏真菌感染是一种罕见的病症，已在早产儿和糖尿病或免疫功能低下的成年患者中报告过。念珠菌属是最常见的相关微生物。本文报告了一例免疫功能正常的膀胱外翻新生儿，他因双侧肾曲霉病（黄曲霉）而患有急性肾衰竭。新生儿通过双侧肾造口管接受两性霉素 B 尿路灌洗，同时联合使用脂质体两性霉素 B 和伏立康唑治疗，这改善了他的肾功能。然而，由于持续的真菌定植，需要进行长期的抗真菌治疗和永久性输尿管造口术，以应对新的输尿管肾盂梗阻发作。截至 2009 年 11 月，尽管存在肾损伤，但肾功能仍得以保留。在这个不寻常的病例中，我们讨论了机械性梗阻的处理和抗真菌药物的选择。
