Ureteropelvic fungal bezoar causing oliguric renal failure in a premature infant.

Systemic candidiasis with renal involvement is a relatively rare infectious process in young infants. The mortality rate in the cases reported to date has been lower after aggressive surgical and medical management. This report concerns a three-month-old, prematurely born infant with a fatal systemic candidiasis and acute renal failure. Renal pelvic fungal balls caused ureteropelvic junction obstruction in this patient. Renal ultrasonography demonstrated bilateral obstructive uropathy. Treatment consisted of surgical removal of the bezoar, together with open placement of nephrostomy tubes, parenteral amphotericin B therapy and peritoneal dialysis. This case emphasizes the need for a highly suspicion of renal obstruction by fungal balls in any high risk infant with systemic candidiasis and renal dysfunction.