Intravesical Fungus Ball Caused by Candida albicans in a Diabetic Patient With Septic Shock: A Case Report

Fungal urinary tract infections (UTIs) are rare. In exceptional cases, fungal colonization can lead to the formation of a "Fungus ball" or fungal bezoar, which may cause urinary tract obstruction and sepsis. We report the case of a 61-year-old male with poorly controlled type 2 diabetes mellitus, presenting with septic shock and anuria. Imaging studies revealed an intravesical mass with air locules, and urine cultures grew <i>Candida albicans.</i> Despite systemic antifungal therapy, persistent obstruction required surgical management. A cystoscopy and open surgical approach allowed complete extraction of a fungal bezoar. Histopathological analysis confirmed fungal structures consistent with <i>Candida</i> spp. The patient recovered after systemic fluconazole therapy, with follow-up imaging showing resolution of obstruction. Urinary tract fungus balls are uncommon and often associated with predisposing factors such as diabetes mellitus, urinary stasis, and prolonged catheterization. Diagnosis requires a high index of suspicion supporting images. Treatment includes systemic antifungal therapy and, in selected cases, surgical removal. Although rare, a urinary fungus ball should be considered in diabetic patients with candiduria and obstructive findings on imaging. Early recognition and combined medical-surgical management are essential for favorable outcomes.