Aspergillosisに於ける腎臓の変化について(汎発性Aspergillosisの1例を中心に)

Abstract

Concerning to fungal infections in the field o f urology, role of candida in the lower urinary tracts has only been studied in the past. In particularlly, aspergillal infection of the kidney has been described simply as a partial and incidental change due to pulmonary or generalized aspergillosis. For these reasons, detail clinico-pathological findings of generalized aspergillosis were studied based on necropsied materials and supplemental experiments using rabbit. The results are summarized as follows. 1. A case of generalized aspergillosis accompanied with acute myelogenous leukemia in a 44 years old male was detailly studied. The renal lesions were found to be occurred by dissemination of spores or stigmata from pulmonary foci through blood circulation. The main histological finding was multiple small fungal abscesses. Namely, focal embolic glomerulitis and miliary or nodulo-granulomatous nephritis of necrotizing or abscessforming types were the chief renal changes in which secondary changes due to circulatory disturbance were participated. 2. In considerin g the characteristics of aspergillus, however, possibilities of direct expansion or lymphatic dissemination of aspergillus into the kidney from infected surrounding tissues must be fairly frequent. 3. In animal experim ents with infusion of aspergillus into rabbit, almost similar renal lesions as the case described above were able to produce. The lesions, however, widely varied from necrotic or purulent embolic glomerulitis to abscess-forming or casious-like foci and cortical multi-sized embolic foci. In prolonged survived animals, tendency of localization or capsulation of infected foci were observed in both non-sensitized and sen sitized animals. 4. In general, since fungal infections are frequently accompanied with severe infections , wasting diseases and malignant neoplasms, sufficient attentions should be towarded to various symptoms during course of diseases, and to detection of aspergillus.