Fungaemia caused by obstructive renal candida bezoars leads to bilateral chorioretinitis: a case report
Autor: | Stefan Latz, Maher Safi, Simone Müller, Karin Weyer, Philipp Krausewitz, Guido Fechner, Stefan Müller, Jörg Ellinger, Johannes Stein |
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Rok vydání: | 2017 |
Předmět: |
medicine.medical_specialty
Percutaneous Antifungal Agents Urology Fulminant Urinary system 030232 urology & nephrology Case Report Candida glabrata Nephrolithotomy Percutaneous 030230 surgery lcsh:RC870-923 Bezoars 03 medical and health sciences 0302 clinical medicine Amphotericin B Renal bezoars Medicine Humans Obstructive nephropathy Fungaemia Candida chorioretinitis biology business.industry Chorioretinitis Candidiasis General Medicine Middle Aged medicine.disease biology.organism_classification lcsh:Diseases of the genitourinary system. Urology Combined Modality Therapy Obstructive Nephropathy Surgery Reproductive Medicine Bezoar Female Kidney Diseases business Fungemia medicine.drug |
Zdroj: | BMC Urology BMC Urology, Vol 18, Iss 1, Pp 1-3 (2018) |
ISSN: | 1471-2490 |
Popis: | Background Renal fungal bezoars are remarkably rare and mostly occur in immunodeficient patients. Only a small number of cases with immunocompetent patients have been published so far. The published treatment approaches comprised systemic antimycotic therapy and surgical or minimal invasive removal of the fungal balls. In some cases irrigation of the renal duct system with amphotericin B was performed. By obstruction of the urinary tract bezoars can lead to infected hydronephrosis and severe urosepsis with high lethality. Fungaemia can cause fungal colonization in different distant organs. Fulminant chorioretinitis and irreversible visual impairment can be the consequence of ocular fundus colonization. The following report highlights that a co-operation between urologists and ophthalmologists is absolutely indispensible in case of fungaemia. Case presentation Hereinafter we describe a case of an immunocompetent 56 years old woman, presenting with flank pain and shivering. The diagnosis turned out to be difficult due to initially negative urine culture. The fungaemia caused by obstructive nephropathy led to bilateral candida chorioretinitis. The patient was treated with intravenous amphotericin b and the bezoar was removed by percutaneous “nephrolitholapaxy”. After two months, a follow up revealed the patient felt well, chorioretinal lesions regressed and urine culture did not show any fungal growth. Conclusion To the best of our knowledge, this is the first case reporting on obstructive renal bezoars, which lead to haematogenous fungus spread and bilateral chorioretinitis. It points out that extensive ophthalmologic examination should be performed in case of fungaemia even if the patient is not suffering from any visual impairment. |
Databáze: | OpenAIRE |
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