A Rare Cause of Urinary Retention Refractory to Conventional Measures: Bladder Fungoma

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.

Keywords: bladder; candida infection; fungus ball; lower urinary tract symptoms; urinary tract infection.

Figure 1. A fluctuating lesion with heterogenous echo 4 x 2 cm in size was detected on ultrasound