title: Successful treatment of fungus balls due to fluconazole-resistant Candida sake obstructing ureter stents in a renal transplant patient.
abstract: Reported here is the case of a 72-year-old renal transplant recipient with stenosis of the neo-ureter requiring stents, who was admitted to hospital with pyonephrosis caused by fungus balls. Fluconazole-resistant Candida sake was grown. Treatment with external drainage of the renal pelvis and intravenous and local administration of caspofungin resulted in relief of the obstruction. Eradication of the infection was achieved by surgical removal of the ureter with all stents and construction of a cysto-pyelostomy.
authors.affiliation: Department of Infectious Diseases, C5P, Leiden University Medical Center, P.O. Box 9600, 2300RC, Leiden, The Netherlands. jwvantwout@planet.nl
authors.forename: S M
authors.initials: SM
authors.lastname: Arend
authors.forename: E J
authors.initials: EJ
authors.lastname: Kuijper
authors.forename: B J
authors.initials: BJ
authors.lastname: de Vaal
authors.forename: J W
authors.initials: JW
authors.lastname: de Fijter
authors.forename: J W
authors.initials: JW
authors.lastname: van't Wout
mesh_terms: D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002175:Candida / Q000187:drug effects / Q000302:isolation & purification*; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D000077336:Caspofungin; D020878:Device Removal; D004359:Drug Therapy, Combination; D054714:Echinocandins; D015725:Fluconazole / Q000494:pharmacology*; D006801:Humans; D016030:Kidney Transplantation; D055666:Lipopeptides; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D010456:Peptides, Cyclic / Q000008:administration & dosage / Q000627:therapeutic use*; D012086:Reoperation; D015607:Stents / Q000382:microbiology*; D007507:Therapeutic Irrigation / Q000379:methods; D016896:Treatment Outcome; D014567:Urography / Q000379:methods
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D000666:Amphotericin B; D015725:Fluconazole; D000077336:Caspofungin