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两性霉素B全身/局部用药联合手术切除成功治疗膀胱真菌球

Successful Treatment of Bladder Fungus Ball Due to With Systemic/Local Amphotericin B and Surgical Excision.

作者信息

Erkol Yilmaz Yağmur, Havan Merve, Eyduran Eda, Penezoğlu Nilay, Öcal Duygu, Teber Serap, Çiftçi Ergin, Soygür Yakup Tarkan, Kendirli Tanıl

机构信息

Department of Pediatrics, Ankara University School of Medicine, Ankara, Türkiye.

Department of Pediatrics, Division of Pediatric Intensive Care, Ankara University School of Medicine, Ankara, Türkiye.

出版信息

Case Rep Pediatr. 2025 May 11;2025:9741756. doi: 10.1155/crpe/9741756. eCollection 2025.

Abstract

Fungal infections in the urine are rare in healthy individuals but can occur in patients with diabetes, immunosuppression, urinary catheterization, prolonged hospital stays, and the use of broad-spectrum antibiotics. The most common strain is , with being the most prevalent. is a new emerged and severe, contagious species of family especially in critically ill patients. We present a case of a 17-year-old male with neuromyelitis optica spectrum disorder who developed a fungus ball in the bladder. Despite multiple antibiotic therapies, persistent fevers led to the diagnosis of and the detection of a fungus ball in the bladder. The patient was successfully treated with caspofungin, cystoscopy for total excision of the fungus ball, and intravesical liposomal amphotericin B. This case underscores the importance of early diagnosis and treatment of fungus balls to prevent complications such as obstructive complications and fungal urosepsis. In conclusion, identifying risk factors, such as immune dysregulation, prolonged PICU stay, mechanical ventilation, urinary catheter, and antibiotic use, is crucial in managing such cases.

摘要

健康个体尿液中的真菌感染很少见,但糖尿病患者、免疫抑制患者、留置导尿管患者、长期住院患者以及使用广谱抗生素的患者可能会发生。最常见的菌株是 ,其中 最为普遍。 是 科新出现的一种严重的传染性物种,尤其在重症患者中。我们报告一例17岁患有视神经脊髓炎谱系障碍的男性患者,其膀胱内形成了真菌球。尽管进行了多种抗生素治疗,但持续发热导致诊断为 并在膀胱中检测到真菌球。该患者通过卡泊芬净、膀胱镜下真菌球全切术以及膀胱内脂质体两性霉素B成功治愈。该病例强调了早期诊断和治疗真菌球以预防诸如梗阻性并发症和真菌性脓毒症等并发症的重要性。总之,识别免疫失调、长时间入住儿科重症监护病房、机械通气、导尿管及抗生素使用等风险因素对于处理此类病例至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebb2/12086029/941e4183050c/CRIPE2025-9741756.001.jpg

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