Jegannathan Devimeenal, Ramanathan Kanagasabai
Department of Radiology, Government Kilpauk Medical College, Dr MGR Medical University, Chennai, India.
BJR Case Rep. 2016 May 8;2(3):20150247. doi: 10.1259/bjrcr.20150247. eCollection 2016.
Fungal ball or fungal bezoar is the saprophytic colonization of a pre-formed cavity by a conglomerate of fungal mycelia without invasion of the adjacent tissue. Fungal bezoar is seen commonly in immunocompromised individuals. We describe the cross-sectional imaging characteristics of two cases of renal fungal ball, a rare clinical entity. The first case is that of a 36-year-old female with diabetes who presented with a single fungal ball that caused ballooning of the renal pelvis by coelomycetes, a rare species of fungi. The second case is that of a 45-year-old immunosuppressed male with diabetes who presented with multiple fungal balls and emphysematous pyelonephritis. Awareness about the various imaging findings of this rare clinical entity and a high index of suspicion in high-risk individuals will help in overcoming the challenges in early diagnosis and, thereby, institution of proper treatment.
真菌球或真菌粪石是由真菌菌丝体聚集在预先形成的腔内进行腐生定植,而不侵犯相邻组织。真菌粪石常见于免疫功能低下的个体。我们描述了两例肾真菌球的横断面成像特征,这是一种罕见的临床实体。第一例是一名36岁患有糖尿病的女性,她出现了一个由腔孢菌(一种罕见的真菌种类)引起肾盂扩张的单一真菌球。第二例是一名45岁患有糖尿病且免疫抑制的男性,他出现了多个真菌球和气肿性肾盂肾炎。了解这种罕见临床实体的各种影像学表现以及对高危个体保持高度怀疑指数,将有助于克服早期诊断中的挑战,从而进行适当的治疗。