Fungus ball in the urinary tract: A rare entity

Valentin Praz1, Rodolfo Burruni1, Florian Meid1

  • 1Centre Hospitalier Universitaire Vaudois, Service of Urology, Lausanne, Switzerland.

Insights

Fungal balls in the urinary tract are rare but dangerous complications of candiduria. Treatment success depends on patient anatomy, sometimes requiring surgical intervention beyond standard antifungal therapy.

Area of Science:

  • Urology
  • Mycology
  • Infectious Diseases

Background:

  • Fungal balls (fungus balls) in the urinary tract are uncommon but severe complications of candiduria.
  • These infections predominantly affect immunocompromised patients.
  • Fungus balls can lead to serious conditions like hydronephrosis and sepsis.

Purpose of the Study:

  • To report two cases of urinary tract fungus balls.
  • To highlight the varied clinical presentations and treatment challenges.
  • To discuss the necessity of tailored treatment approaches based on anatomical factors.

Main Methods:

  • Case report of two patients with urinary tract fungus balls.
  • Treatment involved prompt relief of obstruction via nephrostomy and antifungal agents for the first patient.
  • The second patient required open surgery for fungus ball removal and ureteral reimplantation due to distal ureteral stenosis.

Main Results:

  • The first patient responded well to nephrostomy and antifungal treatment.
  • The second patient did not respond to initial conservative management and required surgical intervention.
  • Successful urinary tract drainage was achieved in both cases, albeit with different modalities.

Conclusions:

  • Urinary tract fungus balls are a significant clinical challenge.
  • While antifungal therapy and obstruction relief are primary treatments, anatomical abnormalities may necessitate surgical management.
  • Individualized treatment strategies are crucial for managing complex cases of urinary tract fungal infections.

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