Urinary tract infection caused by rare yeast Vanrija humicola in a urothelial carcinoma patient: a case report and literature review.
Urinary tract infections from rare fungi are rising in immunocompromised cancer patients. Early diagnosis and antifungal testing of Vanrija humicola are essential to guide treatment and improve outcomes in urothelial carcinoma.
An 82-year-old man with advanced urothelial carcinoma and metastases to the bone and lungs was admitted to Jiangxi Cancer Hospital on September 22, 2025. He presented with urinary frequency, urgency, dysuria, and pain in the left hip. At admission, he was started on cefoperazone-sulbactam for a suspected urinary tract infection. On September 29, he underwent transurethral resection of the prostate. Pathology confirmed a malignant bladder tumor (urothelial carcinoma). Palliative radiotherapy and chemo-immunotherapy with toripalimab, gemcitabine, and cisplatin were initiated on October 10. Urine culture performed on October 10 grew Enterococcus faecalis. An unidentified fungal culture obtained on October 12, which was confirmed as Vanrija humicola by ITS and D1-D2 rDNA sequencing. Antifungal susceptibility showed voriconazole MIC 0.12 mg/L, fluconazole 4 mg/L, amphotericin B <1 mg/L, echinocandins >8 mg/L. He was treated with intravenous voriconazole and amoxicillin-clavulanate, with close clinical monitoring. During treatment, his urinary symptoms gradually resolved, inflammatory markers returned to normal levels, and the pain in his left hip improved. The patient was discharged on October 22, 2025.
This case shows the opportunistic pathogenic potential of V. humicola in immunocompromised patients. Accurate identification and antifungal testing are essential, and clinicians should consider rare fungi for timely, effective treatment.
An 82-year-old man with advanced urothelial carcinoma and metastases to the bone and lungs was admitted to Jiangxi Cancer Hospital on September 22, 2025. He presented with urinary frequency, urgency, dysuria, and pain in the left hip. At admission, he was started on cefoperazone-sulbactam for a suspected urinary tract infection. On September 29, he underwent transurethral resection of the prostate. Pathology confirmed a malignant bladder tumor (urothelial carcinoma). Palliative radiotherapy and chemo-immunotherapy with toripalimab, gemcitabine, and cisplatin were initiated on October 10. Urine culture performed on October 10 grew Enterococcus faecalis. An unidentified fungal culture obtained on October 12, which was confirmed as Vanrija humicola by ITS and D1-D2 rDNA sequencing. Antifungal susceptibility showed voriconazole MIC 0.12 mg/L, fluconazole 4 mg/L, amphotericin B <1 mg/L, echinocandins >8 mg/L. He was treated with intravenous voriconazole and amoxicillin-clavulanate, with close clinical monitoring. During treatment, his urinary symptoms gradually resolved, inflammatory markers returned to normal levels, and the pain in his left hip improved. The patient was discharged on October 22, 2025.
This case shows the opportunistic pathogenic potential of V. humicola in immunocompromised patients. Accurate identification and antifungal testing are essential, and clinicians should consider rare fungi for timely, effective treatment.