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A Rare Cause of Urinary Retention Refractory to Conventional Measures: Bladder Fungoma
Emre B Sahinler1, Orhun Sinanoglu1, Erhan Erdogan1
1Urology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Research and Training Hospital, Istanbul, TUR.
Abstract:
Funguria is a rare condition in healthy populations but in immunocompromised patients, it is occasionally seen and can cause opportunistic urinary tract infections. Candida albicans is the most commonly isolated pathogen in fungal urinary tract infections. The standard treatment for fungal urinary tract infection is anti-fungal therapy. Sometimes when severe funguria is present, a rare entity called a fungus ball can form in the urinary tract and surgical excision may be needed for eradication. In this report, we present a 76-year-old male patient who was admitted to our clinic for anuria for two days. The patient was catheterized transurethrally and saline irrigation was performed. Candida albicans was isolated from the urine. Ultrasound showed a 4 x 2cm fungus ball in the bladder. With the open surgical removal of the fungus ball and anti-fungal therapy with fluconazole, the patient was discharged without any complications. We emphasize that in patients with risk factors, abnormal imaging, and funguria resistant to anti-fungal therapy, fungus ball may be present and surgical removal is the standard approach.
Insights
Fungal urinary tract infections, often caused by Candida albicans, can lead to fungus balls. Surgical removal combined with antifungal therapy is the standard approach for this rare complication.
Area of Science:
- Urology
- Infectious Diseases
Background:
- Funguria, or fungal presence in urine, is uncommon in healthy individuals but can cause opportunistic urinary tract infections (UTIs) in immunocompromised patients.
- Candida albicans is the most frequent pathogen identified in fungal UTIs, typically managed with antifungal therapy.
Observation:
- Severe funguria can rarely lead to the formation of a bladder fungus ball, a condition necessitating surgical intervention.
- A case report details a 76-year-old male presenting with anuria, who was found to have a 4x2cm Candida albicans fungus ball in his bladder.
Findings:
- Transurethral catheterization and saline irrigation were performed, and Candida albicans was isolated from the urine.
- The patient underwent open surgical removal of the fungus ball and received antifungal therapy with fluconazole.
Implications:
- This case highlights that fungus balls should be suspected in patients with risk factors, abnormal imaging, and funguria resistant to antifungal treatment.
- Surgical excision is emphasized as the standard and effective approach for eradicating bladder fungus balls.
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