Genitourinary Fungal Infections (Other Than Vaginal Candidiasis)

Candida species is the most common fungus isolated in the urine of hospitalized patients. In recent years, non-albicans Candida are emerging causes of candiduria. Urinary tract infections (UTIs) by other fungi are very rare. Although most candiduria is asymptomatic, it could be a sign of serious infections especially in critically ill or immuncompromized patients. Urinalysis and urine cultures are primary methods of diagnosis of fungal UTI. However, diagnostic imaging studies can be important tools in localizing foci of infection or complications such as abscess or urinary tract obstruction. Differentiation between asymptomatic candiduria and Candida UTI that requires therapy can be challenging. In many instances, removal of indwelling urinary catheters may eradicate the candiduria. Fluconazole is a preferred agent for UTI due to susceptible candida spp. as it achieves high urine concentration. Amphotericin B is also useful but its use is limited by its significant toxicity. Surgical intervention may require to adequately control or eradicate the fungal UTIs.