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Percutaneous extraction of bilateral renal mycetomas in premature infant using mechanical thrombectomy device
Ming-Chen Paul Shih1, Daniel A Leung, Jonathan A Roth
1Division of Interventional Radiology, Department of Radiology, University of Virginia Health System, Charlottesville, Virginia 22908, USA.
Abstract:
Although mycotic infections of the urinary system occur not infrequently, obstruction of the upper urinary tract because of mycetomas or fungus balls is exceedingly rare. Treatment consists of antifungal treatment and appropriate urinary drainage. In cases resistant to treatment with external drainage and chemotherapy, open surgery is typically performed to remove the mycetoma. However, this can also be achieved percutaneously using mechanical thrombectomy devices, as shown in this case of a 4-month-old infant presenting with renal failure due to bilateral obstructing mycetomas.
Insights
Fungal balls (mycetomas) rarely obstruct the urinary tract, causing kidney failure. Percutaneous mechanical thrombectomy offers a minimally invasive alternative to surgery for removing these fungal obstructions in infants.
Area of Science:
- Urology
- Mycology
- Pediatric Nephrology
Background:
- Fungal infections of the urinary system are uncommon.
- Urinary tract obstruction due to fungal balls (mycetomas) is exceptionally rare.
- Standard treatment involves antifungals and urinary drainage, with surgery reserved for resistant cases.
Observation:
- A 4-month-old infant presented with renal failure.
- The infant had bilateral obstructing mycetomas in the upper urinary tract.
- This case highlights a rare presentation of fungal urinary tract obstruction in a pediatric patient.
Findings:
- Percutaneous mechanical thrombectomy was successfully used to remove bilateral obstructing mycetomas.
- This minimally invasive approach avoided the need for open surgery.
- The infant's renal failure was attributed to the fungal obstruction.
Implications:
- Percutaneous mechanical thrombectomy is a viable alternative to open surgery for managing rare pediatric mycetomas.
- This technique offers a less invasive option for treating urinary tract obstruction caused by fungal balls.
- Early diagnosis and intervention are crucial for managing pediatric renal failure due to mycetomas.
