Abstract
Introduction:
Fungus ball (FB) is a rare condition that often requires surgical management. 1 Percutaneous nephroscopy is rarely described in children to remove FB. 2 We report the case of a two-step bilateral mini-percutaneous nephrolithotomy (PCNL) in an infant. We admitted a 7-month-old boy with a history of severe bilateral ureterohydronephrosis who displayed an early relapse of renal candidiasis after a 5-week treatment with antifungal medication (AF) for bilateral pyelonephritis with Candida albicans. He displayed fatigue and lumbar pain 1 week after the end of the AF treatment. Biology showed a renal insufficiency and bilateral FBs were found out on ultrasound-scan. He required nephrostomies in emergency but after 3 days of treatment, US-scan showed FBs in the right ureter and kidney with a dilation of the pelvis. We decided to perform right mini-PCNL to remove them. The puncture needle was inserted in the right inferior calix under fluoroscopy and ultrasonography guidance. We used a sheath of 11F and a rigid nephroscope of 7.5F. The extraction was completed with a 7.5F flexible ureteroscope through the percutaneous access. Cavities of the right kidney were free of FB after surgery. Four days later, US-scan showed persistent FB on the left side and still, a free right pelvis. The same procedure was performed of the left side. The patient quickly improved and he recovered normal renal function. Three months after the surgery, he was doing well and US-scan was unremarkable.
Conclusion:
To our knowledge, it is the first bilateral mini-PNCL undergone in an infant to extract FB.
Patient Consent Statement:
Authors have received and archived patient consent for video recording/publication in advance of video recording of procedure.
No competing financial interests exist
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Runtime of video: 4 mins 54 secs
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