The document discusses treatment options for a 74-year-old male patient admitted with fever, chills, and rigors who was diagnosed with urosepsis and ketoacidosis. Initial treatment with cefepime and fluconazole provided marginal benefit. Blood and urine cultures grew Candida albicans, Candida glabrata, and E. coli. The document reviews antifungal treatment options and their pros and cons, considering the patient's renal insufficiency and isolated fungal species. It recommends systemic antifungal treatment along with nephrostomy tube placement and local antifungal infusion to remove the fungal obstruction.