LAUSR

FIGURE 1: Ultrasonogram of the left kidney showing a hyperechoic mass in the renal calyx with no posterior shadow cone. A 74-year-old diabetic woman presented to the Emergency Department with a high fever and prostration. She had been recently admitted three times for acute urinary retention resulting from an infection with negative urine culture. Laboratory tests at admission showed high C-reactive protein level (16.7 mg/dL), impaired renal function (Cr 2.42 mg/dL), and pus cells (>70/ high-power field). A kidney ultrasound (Figure 1) revealed heterogeneous deposits in both upper renal calyces with no color flow in the Doppler study. After consulting the radiologist, we suspected fungus balls.