Tomashefski J F, Abramowsky C R
Am J Clin Pathol. 1981 Feb;75(2):190-4. doi: 10.1093/ajcp/75.2.190.
An autopsy series of 42 patients who had visceral candidiasis was studied to determine the incidence and clinicopathologic features of Candida-associated renal papillary necrosis. Papillary necrosis was found in nine patients (21%), associated in all instances with fungal invasion of the kidney. The single most common associated condition was prematurity, present in three neonates, and antibiotic or immunosuppressive therapy was a contributing factor in most instances. The clinical significance of candidal papillary necrosis is unclear because most patients had other causes of renal failure. Antemortem diagnosis is exceptionally difficult and had not been made in any of these patients. Pyelograms have aided in the diagnosis in only one well-documented case in the literature. This study shows that the pathologic features of candidal renal papillary necrosis correlate well with the findings in experimentally induced disease, and that this lesion appears to be more common than previously suspected.
对42例内脏念珠菌病患者的尸检系列进行研究，以确定念珠菌相关肾乳头坏死的发生率和临床病理特征。在9例患者（21%）中发现了乳头坏死，所有病例均伴有肾脏的真菌侵袭。最常见的相关情况是早产，3例新生儿出现早产，大多数情况下抗生素或免疫抑制治疗是一个促成因素。念珠菌性乳头坏死的临床意义尚不清楚，因为大多数患者有其他肾衰竭原因。生前诊断异常困难，这些患者中无一例生前确诊。肾盂造影仅在文献中一个记录良好的病例中有助于诊断。本研究表明，念珠菌性肾乳头坏死的病理特征与实验性诱导疾病的发现密切相关，并且这种病变似乎比以前怀疑的更常见。
