Successful Treatment of Bladder Fungus Ball Due to <i>Candida auris</i> With Systemic/Local Amphotericin B and Surgical Excision

Fungal infections in the urine are rare in healthy individuals but can occur in patients with diabetes, immunosuppression, urinary catheterization, prolonged hospital stays, and the use of broad-spectrum antibiotics. The most common strain is <i>Candida</i>, with <i>Candida albicans</i> being the most prevalent. <i>Candida auris</i> is a new emerged and severe, contagious species of <i>Candida</i> family especially in critically ill patients. We present a case of a 17-year-old male with neuromyelitis optica spectrum disorder who developed a fungus ball in the bladder. Despite multiple antibiotic therapies, persistent fevers led to the diagnosis of <i>Candida auris</i> and the detection of a fungus ball in the bladder. The patient was successfully treated with caspofungin, cystoscopy for total excision of the fungus ball, and intravesical liposomal amphotericin B. This case underscores the importance of early diagnosis and treatment of fungus balls to prevent complications such as obstructive complications and fungal urosepsis. In conclusion, identifying risk factors, such as immune dysregulation, prolonged PICU stay, mechanical ventilation, urinary catheter, and antibiotic use, is crucial in managing such cases.