Acute Renal Dysfunction and Candidemia due to Bilateral Ureteral Obstruction by Candida albicans Fungus Balls-Case...

Presented here is an extremely rare case of bilateral ureteral obstruction due to Candida albicans fungus balls, which led to acute kidney dysfunction and candidemia. An 83-year-old man was brought to our hospital after falling due to poor physical condition. He had been receiving abiraterone acetate for 1 month for metastatic castration-resistant prostate cancer, while past medical history included type II diabetes, cardiovascular disease, and dementia. Blood test results revealed severe liver dysfunction, though whole-body computed tomography (CT) findings showed no abnormalities. Based on the recent therapy course, the patient was diagnosed with drug-induced liver damage caused by abiraterone acetate, and steroid pulse therapy and antibiotic administration were started. On Day 11 after starting that treatment, decreased urine output and renal dysfunction were noted. CT scanning revealed bilateral hydronephrosis and slightly dense masses at the origin of ureteral obstruction on both sides. Subsequently, C. albicans was detected in blood and urine samples, thus fungus balls were determined as the cause of bilateral hydronephrosis. Temporary hemodialysis was required, though clinical symptoms and biochemical findings gradually improved following insertion of bilateral ureteral stents and administration of antifungal therapy, and the patient was discharged 72 days after admission.