Intravesical Fungus Ball Caused by Candida albicans in a Diabetic Patient With Septic Shock: A Case Report

Fungal urinary tract infections (UTIs) are rare. In exceptional cases, fungal colonization can lead to the formation of a "Fungus ball" or fungal bezoar, which may cause urinary tract obstruction and sepsis. We report the case of a 61-year-old male with poorly controlled type 2 diabetes mellitus, presenting with septic shock and anuria. Imaging studies revealed an intravesical mass with air locules, and urine cultures grew Candida albicans. Despite systemic antifungal therapy, persistent obstruction required surgical management. A cystoscopy and open surgical approach allowed complete extraction of a fungal bezoar. Histopathological analysis confirmed fungal structures consistent with Candida spp. The patient recovered after systemic fluconazole therapy, with follow-up imaging showing resolution of obstruction. Urinary tract fungus balls are uncommon and often associated with predisposing factors such as diabetes mellitus, urinary stasis, and prolonged catheterization. Diagnosis requires a high index of suspicion supporting images. Treatment includes systemic antifungal therapy and, in selected cases, surgical removal. Although rare, a urinary fungus ball should be considered in diabetic patients with candiduria and obstructive findings on imaging. Early recognition and combined medical-surgical management are essential for favorable outcomes.