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[婴儿真菌性肾盂肾炎经皮肾造瘘术的管理]

[Management of fungal pyelonephritis with percutaneous pyelostomy in infants].

作者信息

Shen Jing, Xu Shan, Shi Li-ping, Mao Jian-hua, Ye Jing-jing

机构信息

Department of Urology, Children's Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou 310003, China.

出版信息

Zhonghua Er Ke Za Zhi. 2012 Dec;50(12):935-8.

Abstract

OBJECTIVE

To explore the management of fungal pyelonephritis in infants.

METHOD

Data from 5 cases with fungal pyelonephritis, including the clinical situation, laboratory examination, feature of imaging, and treatment were analyzed.

RESULT

All the 5 cases were preterm and low birth weight infants. In 3 cases the disease was unilateral, in 2 cases were bilateral, and acute renal failure occurred. Fungus balls presented on imaging. Urine culture was positive of Candida albicans. Treatment with percutaneous nephrostomy, irrigation and antifungal agent were associated with good prognosis. Only 1 case died. The surviving patients were followed up for 10 - 20 months and the results showed normal growth and development. B-mode ultrasound examination did not show any malformation of the urinary system.

CONCLUSION

Fungal pyelonephritis was commom in preterm infants. Candida albicans was the major pathogenic microorganism. Percutaneous nephrostomy and drainage were effective in patients with urinary obstruction in relief of obstruction, early diagnosis and control of infection.

摘要

目的

探讨婴儿真菌性肾盂肾炎的治疗方法。

方法

分析5例真菌性肾盂肾炎患儿的临床情况、实验室检查、影像学特征及治疗情况。

结果

5例均为早产儿及低体重儿。3例为单侧发病,2例为双侧发病,并出现急性肾衰竭。影像学检查可见真菌球。尿培养白色念珠菌阳性。经皮肾造瘘、冲洗及抗真菌药物治疗预后良好。仅1例死亡。存活患儿随访10 - 20个月,生长发育正常。B超检查泌尿系统无畸形。

结论

真菌性肾盂肾炎在早产儿中常见。白色念珠菌是主要致病微生物。经皮肾造瘘及引流对尿路梗阻患儿解除梗阻、早期诊断及控制感染有效。

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