Fungal Ball in the Urinary Bladder

A 68 year old man with type 2 diabetes presented with dysuria, hematuria, and passage of small fungal balls in his urine after starting treatment with an SGLT2 inhibitor. Urinalysis revealed glucosuria, pyuria, and yeast, while imaging identified a mobile bladder mass. Urine culture confirmed Candida albicans infection, leading to a diagnosis of candida cystitis with fungal balls. The SGLT2 inhibitor was discontinued, and fluconazole therapy resolved symptoms by the 4 week follow up. This case highlights the rare but potential risk of fungal urinary tract infections associated with SGLT2 inhibitors in diabetic patients.

A 68 year old man with type 2 diabetes presented with dysuria, hematuria, and passage of small fungal balls in his urine after starting treatment with an SGLT2 inhibitor. Urinalysis revealed glucosuria, pyuria, and yeast, while imaging identified a mobile bladder mass. Urine culture confirmed Candida albicans infection, leading to a diagnosis of candida cystitis with fungal balls. The SGLT2 inhibitor was discontinued, and fluconazole therapy resolved symptoms by the 4 week follow up. This case highlights the rare but potential risk of fungal urinary tract infections associated with SGLT2 inhibitors in diabetic patients.