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Urine Sediment Findings in Fungal Urinary Tract Infections Caused by Candida spp.
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Mohammad Ghahri   |
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Abstract: (721 Views) |
Fungal urinary tract infection usually means urinary tract infection caused by Candida species with special attention to Candida albicans as the major fungal infectious agent. Fungi are pathogenic agents that can also cause disseminated infections involving the kidneys. Besides Candida, other agents, such as Cryptococcus spp., can cause urinary tract infections. Non-yeast fungi, like some members of the Aspergillus, Mucorales, Blastomyces, and Histoplasma families, can also cause infections, especially among immunocompromised patients. The detection and identification of fungi in urine samples (by microscopy and culture) plays an essential role in the diagnosis of fungal UTI. Leukocyturia is a cardinal sign of urinary tract infections caused both by bacteria or fungi and also is a key sign of the immune response occurring in the urinary tract when the organism faces an UTI. This work explains the urinary findings and clinical picture of patients with fungal UTI caused by Candida spp. and some aspects related to the immune response in fungal UTI, in addition to urinalysis perspectives in this clinical condition. The finding of candiduria in a patient with or without symptoms should be neither dismissed nor hastily treated, but requires a careful evaluation, which should proceed in a logical fashion. Symptoms of Candida pyelonephritis, cystitis, prostatitis, or epididymo-orchitis are little different from those of the same infections produced by other pathogens. Candiduria occurring in critically ill patients should initially be regarded as a marker for the possibility of invasive candidiasis. The first step in evaluation is to verify funguria by repeating the urinalysis and urine culture. Pyuria is a nonspecific finding; the morphology of the offending yeast may allow separation of Candida glabrata from other species. Candida casts in the urine are indicative of renal candidiasis but are rarely seen. With respect to culture, colony counts have not proved to be diagnostically useful. In symptomatic or critically ill patients with candiduria, ultrasonography of the kidneys and collecting systems is the preferred initial study. However, computed tomography is better able to discern pyelonephritis or perinephric abscess. The role of magnetic resonance imaging and renal scintigraphy is ill defined, and prudent physicians should consult with colleagues in the departments of radiology and urology to determine the optimal studies in candiduric patients who require in-depth evaluation.
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| Keywords: Urine Sediment, Urinary Tract Infection, Candida spp., Fungal Infection, Candiduria |
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Full-Text [PDF 1672 kb]
(294 Downloads)
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Type of Study: Review |
Subject:
قارچ شناسی
Received: 2025/03/11 | Accepted: 2025/03/11 | Published: 2025/03/11
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