Amphotericin B bladder irrigation for the treatment of neonatal bladder fungus ball

Abstract

An 801 gram very premature infant was delivered by Cesarian section at 28 weeks gestation and developed invasive Candida parapsilosis infection at 4 weeks of age complicated with obstructive uropathy, bilateral hydronephrosis and bladder fungus ball. The baby was treated with systemic amphotericin B and bladder irrigation with amphotericin B solution. Treatment resulted in complete eradication of the bladder fungus ball and resolution of the obstructive uropathy. The difficulty of performing bladder irrigation in an extremely small premature infant is discussed. This case illustrates the need to investigate for renal involvement in newborns with persistent candidemia and the effectiveness of bladder irrigation with amphotericin B solution in the treatment of bladder fungus balls.

Keywords

Bladder fungus ball - neonate - candidiasis