title: Case report of a ureteral obstruction by Candida albicans fungus balls detected by magnetic resonance imaging in kidney transplant recipient.
abstract: In kidney transplant recipients, acute renal failure resulting from a ureteral obstruction by fungus balls is uncommon. We report a 60-year-old man diagnosed with ureteral obstruction caused by Candida albicans fungus balls early after transplant. Diagnosis was made by a T2-weighted magnetic resonance image, which demonstrated fungus balls as a low-intensity mass in the pelvis and microscopic examination findings in the urine. The patient was treated successfully with an antifungal agent and direct irrigation. It should be noted that fungus balls may cause ureteral obstruction of transplanted kidneys, possibly resulting in graft failure. Imaging of the kidneys and collecting system and aggressive debridement that adds to systemic therapy are necessary for early diagnosis and are central to a successful outcome.
authors.affiliation: From the Department of Urology, Shimane University, Enya Izumo, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Arichi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yasumoto
authors.forename: Kohei
authors.initials: K
authors.lastname: Ogawa
authors.forename: Taichi
authors.initials: T
authors.lastname: Nagami
authors.forename: Haruki
authors.initials: H
authors.lastname: Anjiki
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Nakamura
authors.forename: Yozo
authors.initials: Y
authors.lastname: Mitsui
authors.forename: Takeo
authors.initials: T
authors.lastname: Hiraoka
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sumura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiina
mesh_terms: D000284:Administration, Oral; D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D001630:Bezoars; D002176:Candida albicans / Q000472:pathogenicity*; D002177:Candidiasis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D015725:Fluconazole / Q000008:administration & dosage; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D007507:Therapeutic Irrigation / Q000379:methods; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000175:diagnosis* / Q000382:microbiology* / Q000628:therapy
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole