Candida glabrata fungus ball causing early ureteral obstruction in a renal transplant recipient: a case report

Introduction: Fungal infections in renal transplant recipients are rare but potentially serious complications due to the immunosuppressive therapy required to maintain graft function. Candida glabrata , a less common species that is more resistant to antifungal agents than Candida albicans, is increasingly implicated in post-transplant fungal infections. Case presentation: A 56-year-old female with a history of long-standing insulin-dependent diabetes mellitus complicated by peripheral neuropathy, retinopathy, and diabetic nephropathy underwent a deceased-donor renal transplant. The donor was a 48-year-old brain-dead male with normal renal function; serum creatinine had transiently risen to 1.14 mg/dL during admission but returned to a baseline of 0.79 mg/dL before organ procurement. The donor’s right kidney was transplanted into the recipient’s right iliac fossa using the Lich-Gregoir ureteroneocystostomy technique. A 6 Fr double-J Silastic ureteral stent (ImaJin®, Coloplast, France) was inserted routinely. Discussion: Early detection of C. glabrata fungal balls through urine microscopy and imaging, combined with nephrostomy and local antifungal irrigation, can successfully preserve graft function. The literature shows that management strategies vary widely, highlighting the importance of tailoring therapy to infection severity, patient comorbidities, and procedural considerations. Conclusions: This case highlights the importance of early recognition and individualized management of fungal bezoars in renal transplant recipients, particularly those caused by C. glabrata , a less common and more resistant non-albicans species. While C.