McGhee Nicholas M, Chaudhary Fizah, Yousaf Muhammad Nadeem
Department of Internal Medicine, University of Missouri School of Medicine, Columbia, USA.
Cureus. 2023 Mar 2;15(3):e35691. doi: 10.7759/cureus.35691. eCollection 2023 Mar.
bezoar is a rare pathologic entity characterized by the colonization of a cavity by an aggregate or mass of mycelia due to local or systemic infections with spp. bezoar is commonly seen in immunocompromised individuals and can often present in the context of symptomatic urinary tract infection or urosepsis. The implicated risk factors for the development of bezoars are anatomical urinary tract abnormalities, diabetes mellitus, indwelling urinary catheters, increased use of broad-spectrum antibiotics, and corticosteroids. Early clinical suspicion is essential for diagnosis to prevent the dissemination of disease and for a favorable prognosis. We report a case of a 49-year-old diabetic male who presents with hematuria, abnormal urinary flow, and left-sided flank pain for four days caused by a bezoar of the urinary bladder resulting in unilateral obstructive uropathy despite the appropriate placement of a ureteral stent. Treatment with left nephrostomy tube, oral fluconazole, and amphotericin bladder irrigation for three days was successful. The patient's condition improved, and he was discharged on fluconazole and was recommended to follow up with urology as an outpatient.
真菌球是一种罕见的病理实体，其特征是由于局部或全身感染某些菌种，菌丝体聚集或形成团块在腔内定植。真菌球常见于免疫功能低下的个体，常出现在有症状的尿路感染或尿脓毒症的背景下。真菌球形成的相关危险因素包括泌尿系统解剖异常、糖尿病、留置导尿管、广谱抗生素使用增加以及皮质类固醇。早期临床怀疑对于诊断至关重要，以防止疾病传播并获得良好预后。我们报告一例49岁糖尿病男性病例，该患者因膀胱真菌球出现血尿、异常尿流和左侧胁腹疼痛4天，尽管输尿管支架放置合适，但仍导致单侧梗阻性肾病。采用左肾造瘘管、口服氟康唑和两性霉素膀胱冲洗治疗3天取得成功。患者病情改善，出院时带氟康唑，并被建议作为门诊患者到泌尿外科随访。
