Fungus ball

The natural history of pulmonary aspergilloma is highly variable. Pulmonary aspergilloma may exist for a long period without any adverse effects. Spontaneous lysis has been reported in up to 10% of the cases. The most common symptom is recurrent hemoptysis, which may cause fatal asphyxia. Treatment of active disease usually consists of resection of the fungus ball or antifungal therapy. 

Sigler L, de la Maza LM, Tan G, Egger KN, Sherburne RK Diagnostic difficulties caused by a nonclamped Schizophyllum commune isolate in a case of fungus ball of the lung. J Clin Microbiol 1995 33 1979-1983. 

Fig. 15.28. Renal candidiasis and US. Fungus ball type. Sagittal scan of the left kidney (limited by the crosses). The dilated cavities contain echogenic ball-shaped material. The dilatation is related to grade V VUR...

In rare instances, obstruction caused by a fungus ball may be treated with a combination of percutaneous nephrostomy and infusion of amphotericin (Fig. 26.3) (Matsumoto et al. 1990). In asymptomatic children with hydronephrosis, antegrade pyelography and pressure measurement (Whitaker test) maybe performed prior to surgical or endouro-logic correction to document the level and nature of the obstruction. Finally, percutaneous nephrostomy... 

Fig. 26.3a,b. Neonate with complicated course developed UPJ obstruction secondary to a fungus ball. Nephrostomy drainage (5-French system) and amphotericin infusion eventually resolved the obstruction, a At diagnosis b 2 weeks later shows... 

Aspergillosis may also develop within the spine (Fig. 3.36), within the pelvis, with tubo-ovarian masses or ureteral compression, or within the renal graft, as a fungus ball (saprophytic colonization of a cavity by fungal hyphae, without invasion of the adjacent tissues) (Johnston et al. 2004). 

Johnston O, Little DM, Hickey D et al (2004) Aspergillus fungus ball within a cadaveric renal transplant graft. Nephrol Dial Transplant 19 1317-1318 Jordan ML, Cook GT, Cardella CJ (1982) Ten years of experience with vascular complications in renal transplantation. J Urol 128 689-692... 

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