Multiple renal aspergillus abscesses in an AIDS patient: contrast-enhanced helical CT and MRI findings |
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Authors: | C P Heussel H-U Kauczor G Heussel M Thelen B Jahn |
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Institution: | (1) Department of Radiology, Johannes Gutenberg University, Langenbeckstrasse 1, D-55131 Mainz, Germany, DE;(2) Institute of Microbiology, Johannes Gutenberg University, Langenbeckstrasse 1, D-55131 Mainz, Germany, DE;(3) Department of Internal Medicine, Johannes Gutenberg University, Langenbeckstrasse 1, D-55131 Mainz, Germany, DE |
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Abstract: | Renal insufficiency or allergic reactions for X-ray contrast agents are frequent limitations in immunocompromised hosts such
as neutropenic or AIDS patients. Due to a better tolerance of contrast agents in MRI, this technique is well suited for investigation
of parenchymal organs. We demonstrate an allergic AIDS patient who presented with fever and flank pain. At sonography, anechoic
renal lesions were supposed to be non-complicated cysts; however, on T2-weighted MRI, the center was of high signal. Dynamic
contrast-enhanced MRI of the kidneys demonstrated an enhancing rim with ill-defined margins. The lesions were supposed to
be multiple bilateral abscesses. Due to the multiple dynamic contrast series, a delayed enhancement of renal parenchyma was
detectable adjacent to the lesion. This was suggested as accompanying local pyelonephritis and an infectious etiology became
more reliable. Aspergillus fumigatus was identified by CT-guided biopsy as the underlying microorganism. The MR appearance of this manifestation has not been
described previously.
Received: 8 June 1998; Revision received: 7 August 1998; Accepted: 26 August 1998 |
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Keywords: | : Helical CT Dynamic MR imaging Kidney Inflammation AIDS Aspergillosis |
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