Kamimura Yoshiho, Segawa Takehiro, Yamaguchi Kazuaki, Masuda Norihiko, Utsunomiya Noriaki, Muguruma Koei, Kawakita Mutsushi
Department of Urology, Kobe City Medical Center General Hospital.
Hinyokika Kiyo. 2010 Aug;56(8):443-5.
A 70-year-old man with a medical history of diabetes mellitus presented to a local clinic with seven days history of right flank pain and fever. Because there was no symptomatic improvement after one-week antibiotic administration, abdominal ultrasonography and computed tomographic scans were performed to show mass lesions in the right hydropelvis, and he was transferred to our hospital. Retrograde pyelography revealed a retrocaval ureter and a ureteral stent was indwelt. After the symptoms improved, the lesions were removed by percutaneous nephrostomy and fungal balls were diagnosed as Candida parapsilosis after culture. After intermittent one-week irrigation of the renal pelvis with normal saline, the nephrostomy tube was removed. In six-month follow-up, mild hydronephrosis remains without fungal ball recurrence. To the best our knowledge, there has been no case report of Candida parapsilosis fungal balls in the urinary tract.
一名有糖尿病病史的70岁男性因右侧胁腹疼痛和发热7天就诊于当地诊所。在给予抗生素治疗一周后症状无改善,遂行腹部超声和计算机断层扫描,结果显示右侧肾盂有肿块性病变,随后他被转至我院。逆行肾盂造影显示下腔静脉后输尿管,并留置了输尿管支架。症状改善后,通过经皮肾造瘘术切除病变组织,培养后诊断真菌球为近平滑念珠菌。在用生理盐水对肾盂进行为期一周的间歇性冲洗后,拔除了肾造瘘管。在6个月的随访中,仍有轻度肾积水,真菌球未复发。据我们所知,此前尚无泌尿道近平滑念珠菌真菌球的病例报告。