Fungus ball in the urinary tract: A rare entity.

A fungal mass in the urinary tract (fungus ball), mainly occurring in compromised patients, is a rare and dangerous complication of candiduria. We report 2 cases of fungus ball associated with hydronephrosis and sepsis. As reported in the literature, we treated the first patient by prompt relief of obstruction by nephrostomy and local and systemic antifungal agent. The second patient failed to respond to this treatment due to a distal ureteral stenosis and required open surgery with fungus ball removal and ureteral reimplantation. Despite a large success in urinary tract drainage with antifungal treatments, some cases need a modified approach due to anatomical modification.

[1]  T. Scanlon,et al.  Ureteric obstruction due to fungus-ball in a chronically immunosuppressed patient. , 2013, Canadian Urological Association journal = Journal de l'Association des urologues du Canada.

[2]  J. Sobel,et al.  Candida urinary tract infections--epidemiology. , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[3]  T. Patterson,et al.  A noninvasive renal fungus ball caused by Rhizopus--a previously unreported manifestation of zygomycosis. , 2010, Medical Mycology.

[4]  M. Kawakita,et al.  [A case of Candida parapsilosis fungal balls in the urinary tract associated with a retrocaval ureter]. , 2010, Hinyokika kiyo. Acta urologica Japonica.

[5]  E. Holler,et al.  Amphotericin B deoxycholate: no significant advantage of a 24 h over a 6 h infusion schedule. , 2007, The Journal of antimicrobial chemotherapy.

[6]  S. Saito,et al.  Acute renal failure as a result of bilateral ureteral obstruction by Candida albicans fungus balls , 2006, International journal of urology : official journal of the Japanese Urological Association.

[7]  G. Cannon,et al.  Case report: bilateral ureteral obstruction secondary to Aspergillus bezoar. , 2006, Journal of endourology.

[8]  R. Low,et al.  Percutaneous nephroscopic removal of obstructing fungal bezoars and endopyelotomy in an infant. , 2003, Journal of Urology.

[9]  B. Chung,et al.  Successfully treated renal fungal ball with continuous irrigation of fluconazole. , 2001, The Journal of urology.

[10]  M. Resnick,et al.  Predisposing factors of systemic fungal infections of the genitourinary tract. , 1995, The Journal of urology.

[11]  C. Lundquist ON PRIMARY MYCOSIS OF THE KIDNEY , 1931 .