Renal fungal balls
Three days of anuria.
Loading Stack -
0 images remaining
Heteroechoic lesions (predominantly hypoechoic with echogenic areas within) filling the dilated pelvicalyceal system. A possible diagnosis is of fungal balls obstructing the pelvicalyceal systems bilaterally.
Given the age of the patient and ultrasound appearance of obstructing primarily hypoechoic masses bilaterally, a possible diagnosis of bilateral fungal balls was proposed. However there is a broad differential diagnosis, including:
- non-fungal pyogenic or inflammatory debris
- blood clot
- tumor (e.g. transitional cell carcinoma)
- sloughed papilla
In this patient, the urine culture revealed a growth of Candida spp. which strongly supports a diagnosis of fungal balls. This possibility has to be considered in lesions filling the pelvicalyceal system in infants and immunosuppressed patients.