Krishnamurthy Sriram, Singh Rakesh, Chandrasekaran Venkatesh, Mathiyazhagan Gopinathan, Chidambaram Meenachi, Deepak Barathi S, Mahadevan Subramanian
a Department of Pediatrics , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry 605006 , India.
b Department of Microbiology , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry , India.
Paediatr Int Child Health. 2018 May;38(2):146-149. doi: 10.1080/20469047.2016.1162392. Epub 2017 Jan 23.
A 7-year-old boy presented with a chronic, indurated, tender left thigh swelling in association with a hypertensive emergency. He had a bilateral moderate degree of hydronephrosis and a left perinephric abscess, and MRI features of posterior reversible encephalopathy syndrome. Histopathological examination of the biopsy specimen demonstrated eosinophilic fasciitis with filamentous fungi. Basidiobolus ranarum was isolated from the culture. The fungus was also isolated from a perinephric fluid aspirate. Computerised tomography of the abdomen demonstrated features consistent with fungal invasion of the pelvic floor muscles and urinary bladder, leading to bilateral hydronephrosis. He required multiple antihypertensive drug therapy and was treated with intravenous amphotericin B, oral itraconazole and potassium iodide. Antihypertensive agents were discontinued after 2 weeks of antifungal therapy. At 6-months follow-up, the hydronephrosis had resolved completely. Perinephric abscess associated with basidiobolomycosis has not been reported previously.
一名7岁男孩出现左大腿慢性、硬结性、压痛性肿胀，并伴有高血压急症。他患有双侧中度肾积水和左侧肾周脓肿，以及后部可逆性脑病综合征的MRI特征。活检标本的组织病理学检查显示为嗜酸性筋膜炎伴丝状真菌。从培养物中分离出蛙粪霉。该真菌也从肾周液体抽吸物中分离出来。腹部计算机断层扫描显示的特征与真菌侵袭盆底肌肉和膀胱一致，导致双侧肾积水。他需要多种抗高血压药物治疗，并接受了静脉注射两性霉素B、口服伊曲康唑和碘化钾治疗。抗真菌治疗2周后停用抗高血压药物。在6个月的随访中，肾积水已完全消退。此前尚未报道过与蛙粪霉病相关的肾周脓肿。
