The extension of fungi can turn into a fungus ball within the renal pelvis or ureters and lead to an obstruction and hydronephrosis. This may result in pyelonephritis with secondary fungemia and sepsis. Dissemination of fungi usually occurs with instrumentation of an immune suppressed or diabetic patient. Retrograde invasion of the kidneys may lead to papillary necrosis. Usual candiduria often resolves with changing the indwelling catheter.
Candida infection is associated with abscess formation, granulocytic vasculitis and meningitis.
Analysis of CSF usually demonstrates moderate increase in neutrophils and mononuclear cells. Intratecal administration of amphotericin B has been used with some success. Pulmonary involvement is usually blood borne. Candida cholecystitis has a high mortality rate, and may extend into hepatosplenic infection in neutropenic patients secondary to aplastic anemia and acute leukemia. Splenectomy has been recommended as a curative treatment for isolated splenic infections if there is no response to medical therapy.