Medical College of Wisconsin, Wausau, Wisconsin,
Medical College of Wisconsin, Wausau, Wisconsin.
WMJ. 2022 Jul;121(2):E27-E30.
Funguria is often a benign and common occurrence in the hospital. However, invasive fungal pyelonephritis due to obstructive uropathy is uncommon and can be difficult to treat. Typically, there are 2 mechanisms by which infects the upper urinary tract: by ascending from the lower urinary tract or via hematogenous spread to the kidneys.
We present a case of fungal pyelonephritis, likely due to obstructive uropathy, leading to fungemia in a 70-year-old man who had a recent history of colovesicular fistula and indwelling foley catheter.
The patient had many identified risk factors contributing to the development of fungal pyelonephritis, including diabetes mellitus and structural urinary tract aberrancies, which were further complicated by his recent colovesicular fistula and repair.
Although fungal pyelonephritis with fungemia is relatively rare, it should not be excluded from differential diagnostics. Despite a unique host of risk factors, a direct approach led to successful treatment.
真菌尿症在医院中通常是良性且常见的，但由于尿路梗阻引起的侵袭性真菌性肾盂肾炎并不常见，且治疗较为困难。通常，有两种机制导致 感染上尿路：从下尿路逆行感染或血行播散至肾脏。
我们报告了一例真菌性肾盂肾炎病例，可能由于尿路梗阻导致菌血症，发生在一名 70 岁男性身上，该患者近期有结肠膀胱瘘和留置 Foley 导管的病史。
该患者存在多种导致真菌性肾盂肾炎发展的明确危险因素，包括糖尿病和结构性尿路异常，而近期的结肠膀胱瘘和修复术使情况更为复杂。
尽管真菌性肾盂肾炎伴菌血症相对罕见，但不应排除在鉴别诊断之外。尽管存在一系列独特的危险因素，但直接的治疗方法取得了成功。
