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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the course of Candida albicans pyelonephritis an infant devleoped acute renal failure as a result of bezoar production with bilateral obstruction of the ureters. As on the one hand "obstructive" Candida pyelonephritis is not a well-recognised cause of renal failure, and on the other a noticeable increase in the number of cases of serious Candida infection with pyelonephritis can be observed during antibiotic and immmunosuppressive therapy, it seems worthwhile to report this case.
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PMID:[Renal failure in an infant due to bilateral ureter obstruction by Candida albicans pyelonephritis (author's transl)]. 90 39

A 69-year-old man was transferred to our hospital because of fever and acute renal failure. 5 weeks prior to admission, he was admitted to another hospital and treated with several antibiotics including vancomycin, but fever did not subside and renal dysfunction showed rapid progression. On admission, laboratory findings revealed pyuria, inflammatory changes, acute renal failure, and disseminated intravascular coagulation (DIC). Computed tomography showed left ureteral stone and hydronephrosis. Gallium scintigraphy showed avid uptake in the left kidney. Serum concentration of vancomycin was 57.4 micro/ml. Candida glabrata was isolated from blood, sputum and urine. Under the diagnosis of fungemia and left pyelonephritis, he was treated with micafungin (150 mg/day), gabexate mesilate and insertion of a double-ended pigtail catheter. The above treatment produced regression of systemic inflammation, DIC and acute renal failure. At the last follow-up 3 weeks after discharge, ureteroscopy showed that the ureter stone had already passed but a soft white-yellowish bezoar was detected in the ureter. In this case, neurogenic bladder, poorly controlled diabetes, and long-term antibiotic treatment probably enhanced the development of C. glabrata infection. Antifungal treatment with micafungin is useful in patients with non-albicans Candida infection.
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PMID:Candida glabrata fungemia in a diabetic patient with neurogenic bladder: successful treatment with micafungin. 1699 45

A six-year-old female entire German shepherd dog was investigated for polyuria, polydipsia and lethargy. Investigations revealed a mild azotaemia and abdominal ultrasound revealed marked bilateral dilation of the renal pelves with echogenic material and proximal left hydroureter. Urine cytological examination and aspirates from the right renal pelvis revealed mats of fungal hyphae consistent with fungal bezoar formation. Fungal cultures revealed a profuse growth of Paecilomyces variotii. Initial treatment with oral itraconazole was unsuccessful, leading to bilateral nephrotomies to remove the fungal material. Postoperatively the Paecilomyces infection persisted despite continued itraconazole therapy. Treatment was commenced with amphotericin B, leading to resolution of the dog's clinical signs. To the authors' knowledge this is the first report of canine Paecilomyces pyelonephritis, without disseminated systemic disease, which documents its successful treatment.
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PMID:Successful treatment of bilateral Paecilomyces pyelonephritis in a German shepherd dog. 2389 7

Aspergillosis is primarily a pulmonary disease so that renal aspergillosis is usually secondary to hematogenous spread from lungs. Primary renal aspergillosis, though a rare entity, is still seen in immuno-compromised individuals. Renal aspergillosis may lead to formation of focal abscesses, fungal bezoars and may cause ureteric obstruction. Treatment involves stabilization of patient and removal of fungal bezoars along with administration of anti-fungal agents. This report describes the case of localized primary renal aspergillosis with fungal bezoar formation in 2 years old immuno-competent child who presented in sepsis and acute renal failure and was successfully managed by nephroscopic removal of fungal bezoar and intravenous voriconazole. The other kidney required nephrectomy for xanthogranulomatous pyelonephritis.
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PMID:Primary renal aspergillosis and xanthogranulomatous pyelonephritis in an immuno-competent toddler. 2490 55

Fungal ball or fungal bezoar is the saprophytic colonization of a pre-formed cavity by a conglomerate of fungal mycelia without invasion of the adjacent tissue. Fungal bezoar is seen commonly in immunocompromised individuals. We describe the cross-sectional imaging characteristics of two cases of renal fungal ball, a rare clinical entity. The first case is that of a 36-year-old female with diabetes who presented with a single fungal ball that caused ballooning of the renal pelvis by coelomycetes, a rare species of fungi. The second case is that of a 45-year-old immunosuppressed male with diabetes who presented with multiple Candida albicans fungal balls and emphysematous pyelonephritis. Awareness about the various imaging findings of this rare clinical entity and a high index of suspicion in high-risk individuals will help in overcoming the challenges in early diagnosis and, thereby, institution of proper treatment.
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PMID:Renal fungal ball-two case reports and review of literature. 3045 67