fungal cystitis

Etiology: risk factors 1) indwelling catheter (foley) 2) instrumentation of the urinary tract 3) diabetes mellitus 4) prior antibiotic therapy 5) urinary tract pathology 6) malignancy Epidemiology: - common in hospitalized patients Pathology: 1) generally benign 2) most cases represent colonization rather than infection Clinical manifestations: 1) most cases are asymptomatic 2) dysuria, frequency, suprapubic discomfort suggest infection Laboratory: 1) urinalysis - pyuria common with indwelling foley catheter, cannot be used to indicate infection 2) culture: neither presence of pseudohyphae nor number of colonies distinguish colonization from infection Complications: 1) involvement of kidneys is associated with abstruction & vesiculoureteral reflux 2) Candidemia (5% of renal transplant patients with candiduria) Management: 1) removal of foley catheter 2) treatment NOT associated with improved survival 3) rarely requires treatment except with a) neutropenia b) low birth weight neonates c) urinary tract manipulation 4) fluconazole, loading dose 400 mg, then 200 mg QD for 14 days - recurrence is common after fluconazole stopped 5) amphotericin B 0.3-0.7 mg/kg IV for 1-7 days - bladder irrigation with amphotericin B will clear funguria but effect is transient 6) flucytosine 100 mg/kg/day divided QID for 5-7 days

General

cystitis mycosis; fungal infection

References

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