Anuria in a solitary kidney with Candida bezoars managed conservatively

Bilateral renal fungal bezoars in a preterm infant: case report and literature review

Renal fungal bezoars or fungal balls is a rare condition in neonates and infants, usually occurring in immunocompromised patients. Renal bezoars result from accumulations of fungal cells and renal epithelial cells. The most common manifestation is candiduria, which can cause urinary tract obstruction. The treatment of choice is prompt medical or surgical intervention, as indicated to eliminate the infection and preserve renal function. Herein we report the case of a 34-week preterm male infant who presented with feeding intolerance, fever, acute kidney injury and alteration of consciousness. His initial creatinine was 3.4 mg/dL and urine analysis showed pyuria and yeast cells. A renal ultrasound demonstrated a dilated bilateral renal pelvis and calyx with bilateral fungal bezoars. The management was intravenous fluconazole with bilateral nephrostomy tubes and later surgical removal of bilateral fungal balls.

Management of an Extremely Low Birth Weight Infant with Bilateral Renal Obstruction Caused by Candida albicans Fungus Balls

We report an extremely low birth weight infant with anuria caused by bilateral Candida albicans fungus balls it was treated with a combination of antifungal therapy, irrigation and pyelotomy. This lead to a recovery of renal function, after a follow-up of 77 month no more Candida was cultured from urine.

Acute kidney injury due to bilateral ureteral obstruction in children

Bilateral ureteral obstruction in children is a rare condition arising from several medical or surgical pictures. It needs to be promptly suspected in order to attempt a quick renal function recovery. In this paper we concentrated on uncommon causes of obstruction, with the aim of giving a summary of such multiple, rare and heterogeneous conditions joint together by the common denominator of sudden bilateral ureteral obstruction, difficult to be suspected at times. Conversely, typical and well-known diseases have been just run over. We considered pediatric cases of ureteral obstruction presenting as bilateral, along with some cases which truly appeared as single-sided, because of their potential bilateral presentation. We performed a review of the literature by a search on PubMed, CrossRef Metadata Search, internet and reference lists of single articles updated to May 2014, with no time limits in the past. Given that we deal with rare conditions, we decided to include also papers in non-English languages, published with an English abstract. For the sake of clearness, we divided our research results into 8 categories: (1) urolithiasis; (2) congenital urinary tract malformations; (3) immuno-rheumatologic causes of ureteral obstruction; (4) ureteral localization of infections; (5) other systemic infective causes of ureteral obstructions; (6) neoplastic intrinsic ureteral obstructions; (7) extrinsic ureteral obstructions; and (8) iatrogenic trigonal obstruction or inflammation. Of course, different pathogenic mechanisms underlay those clinical pictures, partly well-known and partly not completely understood.