Renal fungal ball—two case reports and review of literature

Jegannathan, Devimeenal; Ramanathan, Kanagasabai

doi:10.1259/bjrcr.20150247

Cited by 8 publications

(6 citation statements)

References 7 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Candida albicans is the most common species and accounts for 50–70% of all Candida-related urinary tract infections, followed by Candida glabrata and Candida tropicalis [ 4 ]. Many other fungal isolates have been described in the literature including Aspergillus spp., Mucormycetes spp., Cryptococcus spp., Histoplasma spp., Rhizopus oryzae and Geotrichum candidum [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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

Kittaweerat

Attawettayanon

Choorit

et al. 2021

Journal of Surgical Case Reports

View full text Add to dashboard Cite

Renal fungal bezoars or fungal balls is a rare condition in neonates and infants, usually occurring in immunocompromised patients. Renal bezoars result from accumulations of fungal cells and renal epithelial cells. The most common manifestation is candiduria, which can cause urinary tract obstruction. The treatment of choice is prompt medical or surgical intervention, as indicated to eliminate the infection and preserve renal function. Herein we report the case of a 34-week preterm male infant who presented with feeding intolerance, fever, acute kidney injury and alteration of consciousness. His initial creatinine was 3.4 mg/dL and urine analysis showed pyuria and yeast cells. A renal ultrasound demonstrated a dilated bilateral renal pelvis and calyx with bilateral fungal bezoars. The management was intravenous fluconazole with bilateral nephrostomy tubes and later surgical removal of bilateral fungal balls.

show abstract

Section: Introductionmentioning

confidence: 99%

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

Kittaweerat

Attawettayanon

Choorit

et al. 2021

Journal of Surgical Case Reports

View full text Add to dashboard Cite

show abstract

“…In the renal parenchyma, fungal ball causes pyelonephritis and cortical abscess, while, in the draining system, the ball can lead to obstructive uropathy, most commonly at the level of ureteropelvic junction. Most reported cases of fungal ball are secondary to disseminated candidiasis, but literature also reveals that this type of disease, as in our patient, can be representative of an ascending process [ 4 ]. A workup including blood culture and if positive ophthalmological exam and echocardiogram to rule out systemic candidiasis is required in the presence of Candida sp.…”

Section: Discussionmentioning

confidence: 59%

Fungal Bezoar: A Rare Cause of Ureteral Obstruction

Zeineddine

Mansour

Bitar

et al. 2017

Case Reports in Infectious Diseases

View full text Add to dashboard Cite

A 52-year-old male, with diabetes mellitus and alcoholic liver disease, presented to the Emergency Room for right flank pain of 3 days' duration, associated with dysuria. Physical examination revealed right flank tenderness with fever and hypotension; laboratory findings showed acute kidney injury and large blood and leucocytes in the urine. A CT abdomen and pelvis showed hydronephrosis of the right collecting system of a horseshoe kidney with air and hyperdense debris in the renal pelvis. Patient was treated for multisensitive Proteus mirabilis emphysematous pyelonephritis, and a right nephrostomy tube was inserted. Symptoms recurred in 4 weeks, and repeated urine culture grew Candida albicans and CT scan showed same high density material within the right moiety of the horseshoe kidney. Patient underwent ureteroscopy, and a white fluffy material was aspirated from the right renal pelvis. Pathology of the aspirate confirmed the presence of fungal balls. Patient was given 2 weeks of oral fluconazole. Fungal pyelonephritis is unusual and difficult to treat. Candida species is responsible for the clear majority of the cases. A fungus ball should be managed with surgical and medical therapy. This patient had an endoscopic procedure to remove the fungus ball and received fluconazole. His symptoms resolved and urine culture was done before termination of the treatment was negative.

show abstract

“…Although our case demonstrates a complication of localized Candida infection rather than dissemination, the mortality rate of disseminated Candida infections has been reported as high as 44% [6]. Diagnostic modalities include the following: ultrasonogram of the abdomen, non-contrast and contrast-enhanced abdominal CT, and MRI urogram [4].…”

Section: Discussionmentioning

confidence: 73%

“…Candida albicans is the most common fungal species causing fungal bezoars; however, other fungal isolates have been reported in the literature including other Candida spp., Aspergillus spp., Rhizopus oryzae, and Geotrichum candidum [3][4][5]. Candida bezoar infections of the bladder and upper urinary tract are a very rare phenomenon with unknown exact epidemiology.…”

Section: Discussionmentioning

confidence: 99%

“…Several morphological features can be appreciated on abdominal CT/MRI scans, including rounded heterogeneous soft-tissue densities not attached to the urinary tract wall, with or without regions of gas or calcification. MRI signal characteristics of Candida bezoars have been rarely illustrated but include T1 scans being isointense to renal parenchyma while T2 scans being hyperintense to renal parenchyma [4]. The most described treatment approach to manage fungal bezoars is surgical drainage by nephrostomy tube and/or ureteral catheter in addition to the administration of systemic and local antifungal agents such as fluconazole or amphotericin B for a two-week duration [7].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Candida Bezoar of the Bladder Resulting in Obstructive Uropathy: A Case Report

McGhee¹,

Chaudhary²,

Yousaf³

2023

Cureus

View full text Add to dashboard Cite

Candida bezoar is a rare pathologic entity characterized by the colonization of a cavity by an aggregate or mass of mycelia due to local or systemic infections with Candida spp. Candida bezoar is commonly seen in immunocompromised individuals and can often present in the context of symptomatic urinary tract infection or urosepsis. The implicated risk factors for the development of Candida bezoars are anatomical urinary tract abnormalities, diabetes mellitus, indwelling urinary catheters, increased use of broad-spectrum antibiotics, and corticosteroids. Early clinical suspicion is essential for diagnosis to prevent the dissemination of disease and for a favorable prognosis. We report a case of a 49-year-old diabetic male who presents with hematuria, abnormal urinary flow, and left-sided flank pain for four days caused by a Candida bezoar of the urinary bladder resulting in unilateral obstructive uropathy despite the appropriate placement of a ureteral stent. Treatment with left nephrostomy tube, oral fluconazole, and amphotericin bladder irrigation for three days was successful. The patient's condition improved, and he was discharged on fluconazole and was recommended to follow up with urology as an outpatient.

show abstract

Renal fungal ball—two case reports and review of literature

Cited by 8 publications

References 7 publications

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

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

Fungal Bezoar: A Rare Cause of Ureteral Obstruction

Candida Bezoar of the Bladder Resulting in Obstructive Uropathy: A Case Report

Contact Info

Product

Resources

About