Multi-route antifungal administration in the management of urinary Candida glabrata bezoar

Pravin Viswambaram; Jeanie Misko; Matthew Rawlins; Sarah Clark; John Dyer; Dickon Hayne

doi:10.1016/j.eucr.2020.101275

Multi-route antifungal administration in the management of urinary Candida glabrata bezoar

Urol Case Rep. 2020 May 23:33:101275. doi: 10.1016/j.eucr.2020.101275. eCollection 2020 Nov.

Authors

Pravin Viswambaram^{1

2}, Jeanie Misko¹, Matthew Rawlins¹, Sarah Clark¹, John Dyer¹, Dickon Hayne^{1

2}

Affiliations

¹ Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA, 6150, Australia.
² University of Western Australia, UWA Medical School, 35 Stirling Highway, Perth, WA, 6009, Australia.

Abstract

A 65-year-old lady was admitted with urosepsis and imaging suggesting right sided hydronephrosis secondary to a filling defect consistent with a fungal bezoar. An indwelling urinary catheter and a right percutaneous nephrostomy tube were inserted. Candida glabrata cultured from urine was resistant to fluconazole. Amphotericin B was instilled into the renal pelvis via the nephrostomy tube while intravenous liposomal amphotericin was administered daily along with oral flucytosine. This multi-modal antifungal administration was continued for 14 days. Clinical and biochemical improvement was achieved and repeat imaging showed complete resolution of the filling defects and hydronephrosis.

Keywords: Amphotericin B; Hydronephrosis; Percutaneous nephrostomy tube; Urinary fungal bezoar.

Publication types

Case Reports