Successfully treated bilateral renal fungal balls with continuous Anidulafulgin irrigation

A 73-year-old man with a history of type 2 diabetes mellitus, nephrolithiasis, and recurrent urinary tract infections caused by Candida glabrata was admitted to our hospital. Urosepsis was diagnosed and C. glabrata was isolated from urine and blood cultures. Computed tomography intravenous pyelography (CT-IVP) revealed bilateral filling defects caused by renal fungal balls. Treatment initially comprised intravenous anidulafungin coupled with continuous local anidulafungin irrigation via bilateral nephrostomy tubes, which was followed by high-dose oral fluconazole. This regimen successfully eradicated the C. glabrata in follow-up cultures. •Renal fungal balls are rare, especially when caused by C. glabrata.•Treatment usually consists of irrigation with amphotericin B or surgical removal.•Irrigation with anidulafungin may be a good alternative.•Keep fungal balls in mind when filling defects are combined with candiduria.