Fungal bezoars, or fungal balls, are rare pathologic consequences of funguria in immunocompromised patients. Current treatment recommendations are based on expert opinion and low level evidence. We present a case of a Candida glabrata bezoar that was effectively treated with percutaneous amphotericin B instillations. A subsequent literature review is presented to assess the available case reports and treatment outcomes of Candida spp. bezoars in adults.
Get full access to this article
View all access options for this article.
References
1.
PappasPG, KauggmanCA, AndesDR, et al.Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis, 2016; 62:e1–e50.
2.
PlattR, PolkBF, MurdockB, et al.Risk factors for nosocomial urinary tract infection. Am J Epidemiol, 1986; 124:977–985.
KauffmanCA, VazquezJA, SobelJD, et al.Prospective multicenter surveillance study of funguria in hospitalized patients. Clin Infect Dis, 2000; 30:14–18.
5.
GerleRD. Roentgenographic features of primary renal candidiasis. AJR Am J Roentgenol, 1973; 119:731–738.
6.
TurnerR, GrigsbyTH, EnrightJR, et al.Anuria secondary to mechanical obstruction caused by a Candida fungus ball. J Urol, 1973; 109:938–940.
7.
OliveroJ, BacqueF, CarltonCEJr, EknoyanG. Renal complications of drug addiction. Urology, 1976; 8:526–531.
8.
IretonR, KriegerJN, RuddTG, MarchioroTL. Percutaneous endoscopic treatment of fungus ball obstruction in a renal allograft. Transplantation, 1985; 39:453–454.
9.
DoemenyJ, BannerMP, ShapiroMJ, et al.Percutaneous extraction of renal fungus ball. AJR Am J Roentgenol, 1988; 150:1331–1332.
10.
FrancoA, PradosMC, PerdigueroM, OlivaresJ. Fungus ball: a cause of early obstructive uropathy in renal transplantation. Clin Nephrol, 1992; 38:294.
11.
KeungY, KhanA, SkinnerE, DouerD. Localized renal pelvic fungal ball in a patient undergoing bone marrow transplantation. Acta Haematol, 1993; 89:160–162.
12.
PrazV, BurruniR, MeidF, et al.Fungus ball in the urinary tract: A rare entity. Can Urol Assoc J, 2014; 8:118–120.
13.
OnozawaK, MiyakeN, IwasakiN, et al.A case of Candida albicans fungus balls in the urinary tract appeared during the course of antifungal treatment for Candida endopthalmitis. J Infect Chemother, 2015; 21:687–690.
14.
BerlangaG, MachenGL, LowryPS, BrustKB. Management of renal fungal bezoar caused by multidrug-resistant Candida glabrata. Proc (Bayl Univ Med Cent), 2016; 29:416–417.
15.
JegannathanD, RamanathanK. Renal fungal ball-two case reports and review of literature. BJR Case Rep, 2016; 2:1–4.
16.
LevinDL, ZimmermanAL, FerderLF. Acute renal failure secondary to ureteral fungus ball obstruction in a patient with reversible deficient cell-mediated immunity. Clin Nephrol, 1975; 4:202–210.