Postrenal azotemia due to C. albicans pyocystitis and a Candidal plug.
BACKGROUND
There are many causes of acute renal failure, with cases often being classified as pre-renal, intrarenal or post-renal based on the etiology. A post-obstructive etiology is responsible in a minority of patients. Infectious causes of post-obstructive azotemia are even more rare, but as this case illustrates, should be considered as part of the differential.


METHODS
This case report describes a patient who developed acute renal failure (ARF) while hospitalized. Examination showed a candidal plug at his urethral meatus. Bladder washings removed a significant amount of purulent material. Treatment for C. albicans with fluconazole resolved his urinary retention and his bilateral hydronephrosis. His acute renal failure was due to an infectious, post-obstructive pyocystitis and formation of a candidal plug in his urethral meatus.


CONCLUSIONS
Removal of the candidal plug and treatment of his infection with fluconazole resulted in return to baseline renal function. While not common, an infectious cause of post-renal azotemia should be considered in the appropriate clinical situation.
Olson
Douglas P
DP
George Washington University School of Medicine, Washington, DC 20422, USA.
Mrkoci
Dragica K
DK
D053099:Azotemia / Q000382:microbiology*; D002176:Candida albicans / Q000502:physiology*; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography