URINARY FUNGAL BEZOARS IN CHILDREN - REPORT OF 2 CASES

We report two cases of urinary obstruction by fungal bezoars in full-t erm neonates who presented a uropathy detected antenatally. Early perc utaneous urinary diversion was performed to relieve renal impairment s econdary to a primary megaureter in the first case and to bilateral pe lvi-ureteral obstruction in the second. Acute fungal obstruction occur red first on the side of the primary megaureter and then oil the healt hy side in the first patient. Symptoms of infection and impaired renal function led to a diagnosis of fungal bezoar. In the second patient t he development of the bezoar was more insidious and occurred after sur gical correction of the obstructive pelvi-ureteral junction on the lef t side. Candiduria was the first sign in both cases. Ultrasonography i s the best method to visualize fungal masses within the collecting sys tem. In most cases, percutaneous nephrostomy allows relief of the obst ruction, sampling of urine for culture and irrigation with amphoterici n B. However, additional surgical intervention may be necessary. Syste mic antifungal treatment using mainly 5-flucytosine is also given.