Objectives: Few data exist concerning the combined use of fluconazole syste
mically and as an irrigant for nephrostomy tubes in a patient with renal ca
ndidiasis. The patient described here presented with renal fungal balls obs
tructing the drainage of urine from her nephrostomy tubes. Methods: Twelve
months after chemoradiation for a stage IIB squamous cell carcinoma of the
uterine cervix, a 35-year-old woman presented with renal obstruction necess
itating insertion of ureteral stents. After 6 months of chemotherapy, the p
atient developed uremia. After nephrostomy tubes were placed, renal candidi
asis was noted, and fluconazole was begun systemically. When the renal cand
idiasis failed to clear, nephrostomy tube irrigations were begun. Results:
Fourteen days of therapy with fluconazole resulted in the resolution of the
uremia. The patient died 6 months later with her nephrostomy tubes in situ
and without evidence of candidiasis in her urinary tract. Conclusions: The
patient described was successfully treated without having to remove her ne
phrostomy tubes. Two other authors have reported the successful use of fluc
onazole irrigation to treat candidiasis in nephrostomy tubes that was unres
ponsive to systemic fluconazole. Before the appearance of these reports, th
e best results were obtained with removal of the catheter in renal candidia
sis.