Renal fungal balls causing anuria

Case contributed by Dr Paresh K Desai

Presentation

An infant presents in emergency department with three days of anuria.

Patient Data

Age: 1
Gender: Male
Ultrasound

Ultrasound revealed heteroechoic lesions (predominantly hypoechoic with echogenic areas within) filling the dilated pelvicalyceal system. We gave a possible diagnosis of fungal balls obstructing the pelvicalyceal systems on both sides.

Case Discussion

Ultrasound revealed heteroechoic lesions (predominantly hypoechoic with echogenic areas within) filling the dilated pelvicalyceal system. We gave a possible diagnosis of fungal balls obstructing the pelvicalyceal systems on both sides.

Differential diagnosis:

  1. Non-fungal (bacterial) Pyogenic debris
  2. Blood clot
  3. Tumour (Transitional cell carcinoma)
  4. Sloughed papilla

Final diagnosis:

Urinary culture revealed a growth of Candida sp. This possibility has to be considered in lesions filling the pelvicalyceal system in infants and immunosuppressed patients.

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Case information

rID: 5746
Case created: 20th Mar 2009
Last edited: 15th Dec 2015
System: Urogenital
Inclusion in quiz mode: Included

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