Bilateral renal fungal bezoars in a preterm infant: case report and literature review

Kittaweerat, Nawaporn; Attawettayanon, Worapat; Choorit, Teeranop; Chalieopanyarwong, Virote; Pripatnanont, Choosak; Tanaanantarak, Pattama; Dissaneewete, Pornsak

doi:10.1093/jscr/rjab436

Cited by 3 publications

(4 citation statements)

References 12 publications

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“… 20 Ultrasound shows the bezoars as a hyperechoic lesion on renal or bladder ultrasonography. 10 , 21 As in our case, a non-contrasted CT scan could show the fungal balls as low density lesions which might resemble urinary stones and may be reported mistakenly as such. 12 However, as in other reported cases, a CT scan might only show hydronephrosis, fatty stranding around the kidney, and rarely air bubbles without an identifiable lesion of the bezoar, in such cases, a CT scan with an excretory phase can identify the bezoars as filling defects.…”

Section: Discussionsupporting

confidence: 54%

“… 3 , 5 , 9 Fungal balls could be also directly extracted using flexible ureteroscopy, cystoscopy, PCNL, or by surgical exploration in more complicated cases. 10 - 14 ,21,22 In our case, the treatment of the fungal balls with a systemic antifungal agent (fluconazole) was sufficient enough for a complete eradication of an extensive fungal bezoar infection that was extending through the calyceal systems, ureters, and urinary bladder.…”

Section: Discussionmentioning

confidence: 65%

“…Renal pelvis and ureteric bezoars might cause an obstruction with hydronephrosis and elevated kidney function test in which case a nephrostomy or a ureteric stent is usually necessary. [9][10][11][12] The bladder outlet may also get obstructed by the fluffy material of the bezoars and in rare cases, it may lead to bladder perforation if not promptly managed by catheterization. 13,14 As in this case, fungal urinary tract infections may spread through the urinary tract to cause an extensive infection through the urinary tract.…”

Section: Discussionmentioning

confidence: 99%

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Extensive Urinary Tract Fungal Bezoars Causing Anuria: A Case Report

Alrabadi,

Alsabatin,

Masadeh

et al. 2023

Clin Med Insights Case Rep

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Fungal bezoar formation is a complication of fungal urinary tract infections that are usually caused by Candida species and other fungal types. They can form in any site along the urinary tract and may cause an obstruction to the urine flow that would require drainage by nephrostomy, a ureteric stent, and sometimes surgical intervention is needed. In this case report we discuss a case of an adult male who had an extensive fungal bezoar infection caused by Candida tropicalis causing him anuria and acute kidney injury. The bezoars were found in the bladder, the ureters, and both kidneys. The patient was treated with bilateral ureteric stent insertion and with fluconazole for 3 weeks. Bilateral ureteroscopy and urine culture were done after 2 months and they showed that the bezoars have been eradicated on both gross and microscopic levels.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Extensive Urinary Tract Fungal Bezoars Causing Anuria: A Case Report

Alrabadi,

Alsabatin,

Masadeh

et al. 2023

Clin Med Insights Case Rep

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“…Renal fungal bezoars may be a cause of renal insufficiency, especially in paediatric patients 5. There are even reports about bilateral renal fungal bezoars in infants causing acute kidney failure 6. Das et al reported a case series of two patients who underwent percutaneous lithotomy for bilateral radiolucent staghorn calculi, but pathology revealed the presence of fungal bezoars, and the patients were eventually treated with antifungal agents 7.…”

Section: Discussionmentioning

confidence: 99%

Vesical fungal bezoars on post-TURBT scar tissue causing obstruction and mimicking urothelial carcinoma

Tsikopoulos,

Papadopoulos,

Anastasiou

et al. 2024

BMJ Case Rep

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Fungal bezoars (fungal balls) are rarely reported in the upper or lower urinary tract. They can be the cause of severe morbidities such as urinary tract obstruction, renal failure and fungaemia. Hereby, we present a rare case of a male patient who underwent transurethral resection of bladder tumour (TURBT), and during his postoperative period, he was diagnosed with bladder fungal bezoars adherent to his resection area. The fungal bezoars were covering an extended area of the right lateral bladder wall, including the right ureteric orifice and causing right urinary tract obstruction. Those findings were manifested only after a relooked cystoscopy and histological evaluation.We aim to present a rare example of fungal bezoars mimicking other pathologies in the urinary tract and review the current literature for similar documentation. We underline the necessity of follow-up examinations for urologists performing TURBT surgeries, including urinalysis, imaging modalities and cystoscopy.

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Obstructive Bilateral Renal Fungal Bezoars in an Extremely Premature Neonate Treated With Antifungals and Urokinase Irrigation: A Case Report and Review of the Literature

Davis,

Yap,

Clark

et al. 2024

Pediatric Infectious Disease Journal

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Background: An ex-27-week gestation female infant developed bilateral forearm nodules at 4 weeks of life during treatment for methicillin-sensitive Staphylococcus aureus bacteremia. A pure growth of Candida albicans was isolated on culture of both sterile aspiration of the forearm abscess and urine without evidence of methicillin-sensitive Staphylococcus aureus. The patient went on to develop bilateral obstructive renal fungal bezoars at 11 weeks of life. Results: Bilateral nephrostomies were required to alleviate obstruction with the addition of local irrigation with amphotericin B deoxycholate. Two weeks later, urokinase via the nephrostomy tubes was added due to an unchanged appearance on ultrasound (US) and ongoing candiduria. A significant reduction in the size of bezoars was seen on US after 3 days. Sterilization of urine culture was achieved 7 weeks into treatment, and resolution of bezoars on US was seen 9 weeks after treatment began. No adverse events occurred from the use of local urokinase. Conclusions: Urokinase irrigation via nephrostomy is an effective and safe adjunctive treatment in refractory obstructive renal candidiasis in neonates.

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Bilateral renal fungal bezoars in a preterm infant: case report and literature review

Cited by 3 publications

References 12 publications

Extensive Urinary Tract Fungal Bezoars Causing Anuria: A Case Report

Extensive Urinary Tract Fungal Bezoars Causing Anuria: A Case Report

Vesical fungal bezoars on post-TURBT scar tissue causing obstruction and mimicking urothelial carcinoma

Obstructive Bilateral Renal Fungal Bezoars in an Extremely Premature Neonate Treated With Antifungals and Urokinase Irrigation: A Case Report and Review of the Literature

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