BACKGROUND: There are many causes of acute renal failure, with cases often being classified as pre-renal, intrarenal or post-renal based on the etiology. A post-obstructive etiology is responsible in a minority of patients. Infectious causes of post-obstructive azotemia are even more rare, but as this case illustrates, should be considered as part of the differential. CASE REPORT: This case report describes a patient who developed acute renal failure (ARF) while hospitalized. Examination showed a candidal plug at his urethral meatus. Bladder washings removed a significant amount of purulent material. Treatment for C. albicans with fluconazole resolved his urinary retention and his bilateral hydronephrosis. His acute renal failure was due to an infectious, post-obstructive pyocystitis and formation of a candidal plug in his urethral meatus. CONCLUSIONS: Removal of the candidal plug and treatment of his infection with fluconazole resulted in return to baseline renal function. While not common, an infectious cause of post-renal azotemia should be considered in the appropriate clinical situation.

Keywords: Azotemia - microbiology, Candida albicans - physiology, Kidney Diseases - ultrasonography