Arichi Naoko, Yasumoto Hiroaki, Ogawa Kohei, Nagami Taichi, Anjiki Haruki, Nakamura Shigenobu, Mitsui Yozo, Hiraoka Takeo, Sumura Masahiro, Shiina Hiroaki
From the Department of Urology, Shimane University, Enya Izumo, Japan.
Exp Clin Transplant. 2014 Dec;12(6):559-61. doi: 10.6002/ect.2013.0235. Epub 2014 Jun 25.
In kidney transplant recipients, acute renal failure resulting from a ureteral obstruction by fungus balls is uncommon. We report a 60-year-old man diagnosed with ureteral obstruction caused by Candida albicans fungus balls early after transplant. Diagnosis was made by a T2-weighted magnetic resonance image, which demonstrated fungus balls as a low-intensity mass in the pelvis and microscopic examination findings in the urine. The patient was treated successfully with an antifungal agent and direct irrigation. It should be noted that fungus balls may cause ureteral obstruction of transplanted kidneys, possibly resulting in graft failure. Imaging of the kidneys and collecting system and aggressive debridement that adds to systemic therapy are necessary for early diagnosis and are central to a successful outcome.
在肾移植受者中,由真菌球引起的输尿管梗阻导致急性肾衰竭并不常见。我们报告一名60岁男性,在移植后早期被诊断为由白色念珠菌真菌球引起的输尿管梗阻。诊断通过T2加权磁共振成像做出,该成像显示真菌球为盆腔内的低强度肿块以及尿液的显微镜检查结果。患者通过抗真菌药物和直接冲洗成功治愈。需要注意的是,真菌球可能导致移植肾的输尿管梗阻,可能导致移植失败。肾脏和集合系统的成像以及加强全身治疗的积极清创术对于早期诊断是必要的,并且是成功治疗的关键。