Primary renal candidiasis: fungal mycetomas in the kidney

Fungal infections of the urinary tract have a predilection for drainage structures rather than for the renal parenchyma. Of the causal factors, diabetes mellitus, immunosupressed states, AIDS and prematurity are those most commonly encountered. The case of a young, diabetic man whose chief clinical presentation was dysuria is described. On further examination he was found to harbour fungal balls in the right kidney. Radiological manifestations of acute pyelonephritis were also present. Although primary renal candidiasis is often commensurate with systemic fungaemia, he displayed none of the clinical features of disseminate infection and, hence, was treated conservatively with oral antifungal agents. Fortuitously, spontaneous passage of fungal particulate matter in urine was later reported.