Ureteric Obstruction Caused by Yeast-like Fungi

Abstract

Yeast-like fungous infections in the urinary tract are apparently becoming more common. Such infections can cause obstruction of the urinary passages. the authors review one case of their own and eight from the literature. General factors which favour the growth of yeast-like fungi are general debility, immunosuppressive therapy and treatment with broad-spectrum antibiotics. Predisposing local factors in the urinay tract are glycosuria and stenosis. Several of these factors are present simultaneously in association with kidney transplantation, and urinary infections with yeast-like fungi are probably common in patients with transplants. Obstruction of the ureter of a transplanted kidney is deleterious. in case of such obstruction—when no concretions are seen on X-ray and when fungi are demonstrable in the urine sediment or have been found on culture—a fungous bezoar should be suspected. Treatment consists of catheterization of the renal pelvis and instillation of a mycostatic agent, for example, amphotericin B, as well as alkalinization of the urine, since yeast-like fungi do not thrive in an alkaline environment.