Bibler M R, Gianis J T
Department of Internal Medicine, University of Cincinnati College of Medicine, Ohio 45267-0535.
Rev Infect Dis. 1987 Jul-Aug;9(4):790-4. doi: 10.1093/clinids/9.4.790.
Fungus balls of the renal collecting system are rarely of organisms other than Candida. A case of obstructing aspergilloma associated with acute ureteral colic is presented. The clinical features of this case are characteristic of renal aspergillomas in 10 additional cases described in the literature. Ten of the 11 patients were male. Each of the patients had an underlying disease that predisposed to fungal infection. Although all 11 patients were cured, diagnostic evaluation was often protracted as commoner causes of ureteral obstruction were excluded. Successful therapy required evacuation of the obstructing hyphal mass; open surgical procedures were necessary in five instances. Systemic amphotericin B should be reserved for patients with residual infection following removal of the fungus ball. This report emphasizes the need to consider aspergilloma in the differential diagnosis of acute ureteropelvic obstruction in the appropriate patient population.
肾集合系统的真菌球很少由念珠菌以外的生物体引起。本文报告一例与急性输尿管绞痛相关的阻塞性曲菌球。该病例的临床特征与文献中描述的另外10例肾曲菌球病例特征相符。11例患者中有10例为男性。每位患者都有一种易引发真菌感染的基础疾病。尽管所有11例患者均已治愈，但由于排除了输尿管梗阻的常见病因，诊断评估往往耗时较长。成功的治疗需要清除阻塞性菌丝团；5例患者需要进行开放手术。对于真菌球清除后仍有残余感染的患者，应使用全身性两性霉素B。本报告强调，在对合适的患者群体进行急性输尿管肾盂梗阻的鉴别诊断时，需要考虑曲菌球。
