J Clin Nephrol Kidney Dis | Volume 2, Issue 1 | Case Report | Open Access
Sambani E1, Toulkeridis G1, Stangou M1*, Skoularopoulou M1, Ioanna-Theologia L1, Antachopoulos C2, Salpigidis G3, Papagianni A1 and Efstratiadis G1
1Department of Nephrology, Aristotle University of Thessaloniki, Greece
2Department of Pediatrics, Aristotle University of Thessaloniki, Greece
3Department of Urology, Hippokration Hospital, Greece
*Correspondance to: Maria Stangou
Fulltext PDFThe presence of diabetes predisposes to severe urinary infections, such as emphysematous pyelonephritis and cystitis, perinephric abscesses and renal candidiasis.
We present a case of severe fungal kidney infection, complicated by bilateral fungus balls in a 20-year old diabetic female. The patient presented to the Emergency Department with high fever (38.5ºC), fatigue and back pain. She had poor control of diabetes, with a long history of multiple episodes of diabetic ketoasidosis. Clinical examination revealed positive Giordano sign and sensitivity in the right lateral abdominal area. Laboratory tests on admission showed high ESR, CRP, normal white cell counts impaired renal function and pyuria. Kidney ultrasound and abdominal CT scans revealed bilateral kidney hypertrophy, mild hydronephrosis of the right kidney and severe thickening of ureter and bladder wall. The patient was successfully treated with intravenous fluconazole and amphotericin B for almost three months, in combination with bilateral nephrostomy placements, local infusions of amphotericin B through the nephrostomies and removal of the fungus balls. After repeated negative blood and urine cultures, normal kidney ultrasounds and abdominal CT scans the nephrostomies were removed. The patient was discharged after 152 days of hospitalisation, afebrile, with stabilized renal function and negative blood and urine cultures.
Urinary tract infection; Diabetes mellitus; Fungus balls
Sambani E, Toulkeridis G, Stangou M, Skoularopoulou M, Ioanna-Theologia L, Antachopoulos C, et al. Diabetic Patient with Fungal Renal Infection and Fungus Balls: Case Study. J Clin Nephrol Kidney Dis. 2017; 2(1): 1006.