University of Wisconsin–Madison Medical College of Wisconsin

Fungal Pyelonephritis and Fungemia Due to Obstructive Uropathy

Margaret W. Lieb, MS; Jennifer J. Dennison, MD; Ateeq Mubarik, MD

WMJ. 2022;121(2):e27-e30

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Introduction: Funguria is often a benign and common occurrence in the hospital. However, invasive fungal pyelonephritis due to obstructive uropathy is uncommon and can be difficult to treat. Typically, there are 2 mechanisms by which Candida albicans infects the upper urinary tract: by ascending from the lower urinary tract or via hematogenous spread to the kidneys.

Case Presentation: We present a case of fungal pyelonephritis, likely due to obstructive uropathy, leading to fungemia in a 70-year-old man who had a recent history of colovesicular fistula and indwelling foley catheter.

Discussion: The patient had many identified risk factors contributing to the development of fungal pyelonephritis, including diabetes mellitus and structural urinary tract aberrancies, which were further complicated by his recent colovesicular fistula and repair.

Conclusion: Although fungal pyelonephritis with fungemia is relatively rare, it should not be excluded from differential diagnostics. Despite a unique host of risk factors, a direct approach led to successful treatment.

Author Affiliations: Medical College of Wisconsin, Wausau, Wisconsin (Lieb, Dennison); Ascension Saint Michael’s Hospital, Stevens Point, Wisconsin (Mubarik).
Corresponding Author: Margaret Lieb, email; ORCID ID 0000-0002-3930-8921
Funding/Support: None declared.
Financial Disclosures: None declared.
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