Open AccessFungus ball and emphysematous cystitis secondary to Candida tropicalis: A case report
Author(s) -
Lei Wang,
Xiang Ji,
Guiju Sun,
Ying-chao Qin,
Miaozi Gong,
Jinxia Zhang,
Ning-chen Li,
Yan-qun Na
Publication year - 2015
Publication title -
canadian urological association journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.477
H-Index - 38
eISSN - 1920-1214
pISSN - 1911-6470
DOI - 10.5489/cuaj.3008
Subject(s) - fluconazole , urinary system , candida tropicalis , antifungal , medicine , fungus , diabetes mellitus , urinary bladder , saline , surgery , biology , endocrinology , dermatology , botany
Fungus ball and fungal emphysematous cystitis are two rare complications of fungal urinary tract infection. A 53-year-old male patient presented with these complications caused by Candida tropicalis simultaneously. The predisposing factors were diabetes mellitus and usage of broad-spectrum antibiotics. The fungus ball, measuring 3.5 × 2.0 cm on the left wall of the urinary bladder, shrank significantly to 1.6 × 0.8 cm after 5 days of intermittent irrigation with saline before surgery. With transurethral removal of the fungus ball and antifungal treatment with fluconazole, the patient fully recovered. We conclude that a bladder fungus ball and fungal emphysematous cystitis should always be suspected in patients with diabetes mellitus with uncontrolled funguria and abnormal imaging. Treatment should include a systemic antifungal therapy and thorough surgical removal of the fungus ball. A systemic antifungal therapy combined with a local irrigation with saline or antifungal drugs might help decrease the dissemination of fungemia during an invasive manipulation.