candiduria urology

Candiduria is rare in newborns and infants, occurring most often in patients with risk factors. When associated with a candidal bezoar in the urinary tract, candiduria is usually treated by systemic amphotericin B and flucytosine plus local irrigation with amphotericin B. We describe the successful treatment of five newborns with a urinary tract infection, on major urological malformations, due to Candida albicans (including three with a candidal bezoar) by fluconazole alone. No adverse effects or recurrences were observed...

Recent findings on the epidemiology and treatment of funguria are reviewed. Funguria, or candiduria, is a common nosocomial condition and may develop as early as the first two weeks of hospitalization. Risk factors include antibacterial therapy, an indwelling urinary catheter, urologic procedures, female sex, diabetes, and immunosuppressive therapy. Candida albicans is the species most commonly isolated from the urine of infected patients. Spontaneous resolution of funguria is relatively infrequent. Furthermore, although nonpharmacologic measures, such as removing unnecessary antibacterials and changing or removing indwelling urinary catheters, may be beneficial, they are often inadequate without additional, pharmacologic therapy...

Two elderly patients with obstructive renal calculi who developed Candida albicans bloodstream infection within 12 h following ureteroscopy and ureteral stenting are described. Both patients were treated with prolonged courses of broad-spectrum antibiotics and were found to have urine cultures positive for Candida albicans prior to the urologic procedures. One patient also developed bilateral candidal endophthalmitis. The clinical presentation was indistinguishable from bacteremia complicating manipulation of the urinary tract...

Twenty-six cases of candidemia associated with a well-defined urinary tract source were retrospectively identified and reviewed. Urinary tract abnormalities were present in 23 of 26 patients (88%), 19 (73%) of whom had urinary tract obstruction. Nineteen patients had undergone urinary tract procedures before the onset of candidemia. Episodes of candidemia were brief and low-grade in intensity (median duration, 1 day; median colony count, 1.5 cfu/10 mL of blood). Only eight patients (31%) received > or = 500 mg of amphotericin B...

A detailed analysis of bacteriuria in 148 aged patients with burns was made for a period of 2 years (1991-92), in order to determine the incidence of the urine infections they sustained, the sources and mechanisms of the infections and the impact on the course and outcome of the primary disease. Urine infection was found in 7.6 per cent (46 patients) of all patients treated for burns during the study period; 39.1 per cent were community acquired uroinfection (CAU) and 60.9 per cent were hospital acquired (HAU)...

High urinary colony counts of Candida may develop in patients with prolonged indwelling bladder catheters, multiple antibiotic usage and compromised host resistance. Serum candidal antibody titers may differentiate candidal colonization or early infection from invasive or disseminated infection. The persistence of marked candiduria in the absence of elevated antibody titers or other manifestations of disseminated infection presents a therapeutic dilemma to the urologist. Should the patient be treated with systemic therapy, that is flucytosine or intravenous amphotericin B, or should he be observed until the signs of systemic or renal infection develop? Amphotericin B may be used as a urological irrigant in the management of noninvasive urinary fungal infection...

No abstract text is available yet for this article.

The incidence of genitourinary fungal infections is increasing, and because of their lethal potential, early diagnosis and treatment is mandatory. Candida is the most common urinary fungus and is manifest as renal involvement from systemic candidiasis, primary renal candidiasis, bezoar formation, cystitis, and as asymptomatic candiduria. The clinical status of the patient, serial urine cultures, excretory urogram, and serum candidal titers help to differentiate between the various disease states. Treatment is specific and is based on the clinical manifestation of the disease...