title: Fungus ball and emphysematous cystitis secondary to Candida tropicalis: A case report.
abstract: Fungus ball and fungal emphysematous cystitis are two rare complications of fungal urinary tract infection. A 53-year-old male patient presented with these complications caused by Candida tropicalis simultaneously. The predisposing factors were diabetes mellitus and usage of broad-spectrum antibiotics. The fungus ball, measuring 3.5 × 2.0 cm on the left wall of the urinary bladder, shrank significantly to 1.6 × 0.8 cm after 5 days of intermittent irrigation with saline before surgery. With transurethral removal of the fungus ball and antifungal treatment with fluconazole, the patient fully recovered. We conclude that a bladder fungus ball and fungal emphysematous cystitis should always be suspected in patients with diabetes mellitus with uncontrolled funguria and abnormal imaging. Treatment should include a systemic antifungal therapy and thorough surgical removal of the fungus ball. A systemic antifungal therapy combined with a local irrigation with saline or antifungal drugs might help decrease the dissemination of fungemia during an invasive manipulation.
authors.affiliation: Wu-Jieping Urology Center, Peking University Shougang Hospital, Peking University Health Science Center, Beijing, China;
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Wu-Jieping Urology Center, Peking University Shougang Hospital, Peking University Health Science Center, Beijing, China;
authors.forename: Xiang
authors.initials: X
authors.lastname: Ji
authors.affiliation: Wu-Jieping Urology Center, Peking University Shougang Hospital, Peking University Health Science Center, Beijing, China;
authors.forename: Guo-Feng
authors.initials: GF
authors.lastname: Sun
authors.affiliation: Wu-Jieping Urology Center, Peking University Shougang Hospital, Peking University Health Science Center, Beijing, China;
authors.forename: Ying-Chao
authors.initials: YC
authors.lastname: Qin
authors.affiliation: Department of Pathology, Peking University Shougang Hospital, Peking University Health Science Center, Beijing, China.
authors.forename: Miao-Zi
authors.initials: MZ
authors.lastname: Gong
authors.affiliation: Department of Pathology, Peking University Shougang Hospital, Peking University Health Science Center, Beijing, China.
authors.forename: Jin-Xia
authors.initials: JX
authors.lastname: Zhang
authors.affiliation: Wu-Jieping Urology Center, Peking University Shougang Hospital, Peking University Health Science Center, Beijing, China;
authors.forename: Ning-Chen
authors.initials: NC
authors.lastname: Li
authors.affiliation: Wu-Jieping Urology Center, Peking University Shougang Hospital, Peking University Health Science Center, Beijing, China;
authors.forename: Yan-Qun
authors.initials: YQ
authors.lastname: Na