Sánchez Sanchís M, Pastor Lence J, San Juan de Laorden C, Llopis Guixot B, Tarin Planes M, Carrascosa Lloret V
Servicio de Urología, Hospital Dr. Peset, Valencia, España.
Arch Esp Urol. 1996 Jan-Feb;49(1):66-8.
We report a case of candidiasis of the upper urinary tract that presented as acute renal failure associated with septic syndrome. The patient initially required hemodialysis. Right hydronephrosis and perirenal collection were observed on ultrasound examination.
A percutaneous nephrostomy was performed. Nephrostomy urine cytology and cultures were positive for Candida tropicalis. An anterograde pyelography showed a 'fungus ball' in the urinary tract.
Therapy with oral fluconazole and percutaneous amphotericin B achieved excellent results.
Candidiasic urinary infection of the upper urinary tract often produces obstructive uropathy requiring percutaneous nephrostomy, which can also be used to instill amphotericin B. Combination therapy with amphotericin B and fluconazole can achieve excellent results.
我们报告一例上尿路念珠菌病，表现为与脓毒症综合征相关的急性肾衰竭。患者最初需要血液透析。超声检查发现右肾积水和肾周积液。
进行了经皮肾造瘘术。肾造瘘尿液细胞学检查和培养显示热带念珠菌阳性。顺行肾盂造影显示尿路中有“真菌球”。
口服氟康唑和经皮注射两性霉素B治疗取得了良好效果。
上尿路念珠菌性尿路感染常导致梗阻性尿路病，需要经皮肾造瘘术，该方法也可用于注入两性霉素B。两性霉素B和氟康唑联合治疗可取得良好效果。
