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Fungal Pyelonephritis and Fungemia Due to Obstructive Uropathy

Margaret W Lieb1, Jennifer J Dennison2, Ateeq Mubarik3

  • 1Medical College of Wisconsin, Wausau, Wisconsin, mlieb@mcw.edu.

WMJ : Official Publication of the State Medical Society of Wisconsin
|July 20, 2022
PubMed
Abstract

Insights

Invasive fungal pyelonephritis, a rare but serious condition, can arise from urinary tract obstruction. Prompt diagnosis and treatment are crucial for successful outcomes in patients with risk factors like diabetes and fistulas.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Urology

Background:

  • Fungal pyelonephritis, particularly invasive forms, is uncommon but can be severe.
  • Candida albicans can infect the upper urinary tract via ascending or hematogenous routes.
  • Obstructive uropathy significantly increases the risk of invasive fungal infections.

Observation:

  • A case of invasive fungal pyelonephritis leading to fungemia is presented.
  • The patient was a 70-year-old male with a history of colovesicular fistula and indwelling Foley catheter.
  • Risk factors included diabetes mellitus and structural urinary tract abnormalities.

Findings:

  • The patient developed invasive fungal pyelonephritis complicated by fungemia.
  • Obstructive uropathy was the likely cause, exacerbated by a colovesicular fistula.
  • Successful treatment was achieved through a direct therapeutic approach.

Implications:

  • Fungal pyelonephritis with fungemia, though rare, must be considered in differential diagnoses.
  • Identifying and managing risk factors are key to preventing and treating this condition.
  • A direct treatment strategy can be effective even in complex cases.

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