Candida organisms are common
fungal saprophytes of the gastrointestinal tract, oral cavity, and
vagina.1 However, if host resistance
is altered by chronic disease, malignancy, diabetes mellitus, adrenocorticosteroids, or antibiotics, Candida species may be found in sites
normally free of saprophytic infection. When these organisms become
systemic invaders of man, they
usually produce a fatal, fulminant
clinical course with candidemia,
fever, hypotension, tachycardia, and
invasion of the lungs, heart, and
kidney.2-5 On rare occasion, they
may become a primary, pathogenic
invader of the kidneys without the
presence of candidemia or other
systemic organ involvement.6 A total
of nine well-documented cases of
primary renal candidiasis in adults
have been reported since Albers7
described the first two patients in
The purpose of this communication is to review the nine previous
patients with adult primary renal
candidiasis and report two additional
patients with very unusual features.
Both of our patients had juvenile
diabetes, and neither demonstrated
generalized systemic candidiasis or
candidemia. One patient presented
to the hospital after he passed on
urination several large fungus balls
which consisted of C albicans pseudomycelial elements (Fig 1 and 2).
The second patient developed a C
albicans perinephric abscess which
is believed to be the result of metastatic seeding from a previous C
albicans skin abscess. The passage
of fungus balls or the occurrence of
a perinephric abscess has not been
previously observed in primary renal candidiasis. Both patients were
treated with intravenous doses of
amphotericin B, and both have survived for a long interval with no
evidence of recurrent C albicans infection.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 46
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.