McMaster Section Editor(s): Mark Loeb
Section Editor(s) in Interna Szczeklika: Franciszek Kokot, Robert Drabczyk
McMaster Author(s): Dominik Mertz
Author(s) in Interna Szczeklika: Jan Duława, Robert Drabczyk
How to Cite This Chapter: Mertz D, Duława J, Drabczyk R. Candiduria. McMaster Textbook of Internal Medicine. Kraków: Medycyna Praktyczna. https://empendium.com/mcmtextbook/chapter/B31.II.14.8.9 Accessed February 17, 2019.
Last Updated: March 11, 2015
Last Reviewed: October 4, 2018
Main Documents Taken Into Account:
Guidelines on Urological Infections. European Association of Urology. Available at http://uroweb.org/wp-content/uploads/19-Urological-infections_LR2.pdf
. Accessed 24 March 2015.
Gupta K, Hooton TM, Naber KG, et al; Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases.
Clin Infect Dis. 2011 Mar 1;52(5):e103-20. doi: 10.1093/cid/ciq257. Review. PubMed PMID: 21292654.
Hooton TM, Bradley SF, Cardenas DD, et al; Infectious Diseases Society of America. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America.
Clin Infect Dis. 2010 Mar 1;50(5):625-63. PubMed PMID: 20175247.
Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM; Infectious Diseases Society of America; American Society of Nephrology; American Geriatric Society. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults.
Clin Infect Dis. 2005 Mar 1;40(5):643-54. Epub 2005 Feb 4. Erratum in: Clin Infect Dis. 2005 May 15;40(10):1556. PubMed PMID: 15714408.
Diagnosis of candiduria is based on the presence of Candida spp in 2 consecutive urine cultures. Risk factors include diabetes mellitus, indwelling catheters, and antibiotics. The presence of Candida spp in urine usually indicates colonization rather than infection. However, these two clinical situations cannot be distinguished from each other solely on the basis of quantitative urine cultures and the presence or absence of leukocyturia, as the latter can be present in the absence of an active infection.
In the majority of patients, asymptomatic candiduria requires no treatment, with the exception of those who undergo invasive surgical procedures involving the urinary tract, and may be considered for severely immunocompromised patients such as neutropenic patients. In patients at risk for disseminated candidiasis in whom continued catheterization is indicated, replacement of the catheter or intermittent catheterization instead of the indwelling catheter can be considered. Asymptomatic candiduria usually resolves following removal of the catheter or discontinuation of antibiotic therapy.
In rare cases, candiduria may be a sign of kidney infection, which almost always results from hematogenous spread secondary to candidemia and manifests as multiple microabscesses that can be visualized on computed tomography (CT) scans.
Treatment of symptomatic candiduria: Oral fluconazole 200 mg/d for 7 to 14 days or IV amphotericin B 0.3 to 0.7 mg/kg for 3 to 7 days.