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Primary renal candidiasis: fungal mycetomas in the kidney
Burzin S Morris1, Priya D Chudgar, Owais Manejwala
1Department of Radiology, Seth GS Medical College, KEM Hospital, Mumbai, India. kemradf@vsnl.com
Abstract:
Fungal infections of the urinary tract have a predilection for drainage structures rather than for the renal parenchyma. Of the causal factors, diabetes mellitus, immunosupressed states, AIDS and prematurity are those most commonly encountered. The case of a young, diabetic man whose chief clinical presentation was dysuria is described. On further examination he was found to harbour fungal balls in the right kidney. Radiological manifestations of acute pyelonephritis were also present. Although primary renal candidiasis is often commensurate with systemic fungaemia, he displayed none of the clinical features of disseminate infection and, hence, was treated conservatively with oral antifungal agents. Fortuitously, spontaneous passage of fungal particulate matter in urine was later reported.
Insights
This study details a rare case of fungal balls in the kidney of a young diabetic man presenting with dysuria. Conservative oral antifungal treatment was successful, highlighting a less invasive approach for primary renal candidiasis.
Area of Science:
- Nephrology
- Mycology
- Infectious Diseases
Background:
- Fungal urinary tract infections typically affect drainage structures.
- Common risk factors include diabetes mellitus, immunosuppression, AIDS, and prematurity.
Observation:
- A young, diabetic male presented with dysuria and was found to have fungal balls in his right kidney.
- Radiological imaging showed signs of acute pyelonephritis.
Findings:
- The patient had primary renal candidiasis without systemic fungemia.
- Conservative treatment with oral antifungal agents proved effective.
Implications:
- This case highlights successful conservative management of primary renal candidiasis.
- Early diagnosis and targeted oral therapy can be effective in select cases of fungal kidney infections.