Logo American Journal of Case Reports

Call: 1.631.629.4328
Closed: National Holiday

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

04 October 2018 : Case report  Qatar

Treatment of Renal Fungal Ball with Fluconazole Instillation Through a Nephrostomy Tube: Case Report and Literature Review

Unusual setting of medical care, Rare disease

Osama Abdelhaleem Abdeljaleel1E, Ibrahim Alnadhari1ABDEFG*, Sara Mahmoud2EF, Garegin Khachatryan1E, Morshed Salah1E, Omar Ali1E, Ahmad Shamsodini1E

DOI: 10.12659/AJCR.911113

Am J Case Rep 2018; 19:1179-1183

Abstract

BACKGROUND: Urinary tract candida infection can be due either to hematogenous dissemination of the organism or a retrograde infection. In debilitated or immunosuppressed septic patients, who have upper urinary tract obstruction with renal filling defect, fungal infection should be considered. We report on a patient with sepsis and renal fungal ball who was treated with percutaneous nephrostomy and intravenous antifungal agent, but the patient did not respond so instillation of fluconazole through nephrostomy was given.

CASE REPORT: A 60-year-old male patient with a known case of diabetes mellitus with refractory urine retention underwent transurethral resection of the prostate. Postoperatively, the patient developed recurrent high-grade fever with left loin pain, and elevated septic parameters; urine and blood culture were positive for Candida albicans. Computed tomography urography showed left hydronephrosis with filling defect in the left renal pelvis with suspected renal fungal ball. Left percutaneous nephrostomy was performed and intravenous fluconazole started but the fever did not subside, therefore, the treatment was changed to anidulafungin. The patient improved but urine from both the bladder and the nephrostomy remained positive for candida. Instillation of fluconazole at 300 mg in 500 mL normal saline was applied through the nephrostomy tube over 12 hours at 40 mL/hour for 7 days.

CONCLUSIONS: Renal fungal ball is rare but can be serious, especially in immunocompromised patients. Management options for renal fungal ball include intravenous antifungal agents and percutaneous nephrostomy with antifungal instillation of antifungal agents. The objective of this case report was to document treatment success with the use of fluconazole instillation through a nephrostomy tube.

Keywords: Antifungal Agents, fluconazole, Fungemia

Add Comment 0 Comments

In Press

Case report  USA

Rapid Progression of Malignant Peritoneal Mesothelioma Mimicking a Postoperative Complication in a Young Wo...

Am J Case Rep In Press; DOI: 10.12659/AJCR.942948  

0:00

Case report  Italy

Columella Reconstruction Using a Bilateral Nasolabial Flap: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.943913  

0:00

Case report  USA

Successful Surgical Extraction of an Embolized Iliac Vein Stent from the Right Heart: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.943620  

0:00

Case report  China (mainland)

A Forgotten Double-J Ureteric Stent as the Core of a Bladder Stone: A Case Report and Literature Review

Am J Case Rep In Press; DOI: 10.12659/AJCR.943781  

Most Viewed Current Articles

07 Mar 2024 : Case report  USA

Neurocysticercosis Presenting as Migraine in the United States

DOI :10.12659/AJCR.943133

Am J Case Rep 2024; 25:e943133

0:00

10 Jan 2022 : Case report  Germany

A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...

DOI :10.12659/AJCR.935263

Am J Case Rep 2022; 23:e935263

19 Jul 2022 : Case report  Saudi Arabia

Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19

DOI :10.12659/AJCR.936128

Am J Case Rep 2022; 23:e936128

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923