Abstract

Nowadays, fungal urinary tract infections (UTI) are encountered more often at all ages. However, the difficulty in distinguishing between colonization and infection complicates diagnosis and treatment. Besides, there are also questions about which patients should be treated using which agent and for how long. In some cases, local irrigation may be preferred, apart from systemic treatment. Two pediatric patients, who both have a nephrostomy tube (NT) inserted due to severe hydronephrosis with urinary system obstruction, were found to have a UTI at the time of admission, one with fever and the other without fever, and candida species were isolated in urine cultures. Since candiduria persists despite systemic treatment, amphotericin B irrigation was planned. The NT was connected to a drainage bag and serum infusion set with a three-way stopcock. Amphotericin B (50 mg/L in saline) was sent into the renal pelvis and left there for an hour, then drained out. The procedure was performed continuously 24-hours a day for five days. By this way, we didn't need to insert a second NT and gave enough time for the anti-fungal agent to reach the bladder. In children with persistent fungal UTI, local anti-fungal therapy may be preferred to prevent fungus ball development. Usage of only one NT for anti-fungal irrigation of urinary tractus may be useful in these cases.