Background and Purpose:The presence of yeasts in the urine is not synonymous with urinary tract infectionsinceit can result insimple colonization or contamination. Regarding this, it is required to further clarify the epidemiological profile of funguria. Accordingly, the present study was conducted to establish the epidemiology of funguriainthe Mohammed VI Teaching Hospital of Oujda, Morocco.
Materials and Methods:This retrospective studywas conducted onall urine samples sent for cytobacteriological examination to amicrobiology laboratoryover a period of 28 months(i.e., from March 2016 to June 2018). After the removal of duplicates, the urinesampleswere treated according to the recommendations of the medical microbiology standards.
Results:A total of15,165 urine sampleswerecollected. Urinary colonization accounted for 4.94% (n=749) of cases. The infections of the urinary tract accounted for 5.35% (n=811) of cases. Microbial isolates (n=1,669) in colonization and urinary tract infections were dominated by bacteria (93.47%, n=1,560). Furthermore, the yeasts accounted for 6.53% (n=109) of the isolates. Candidaalbicanswas isolated from56.88% (n=62) of funguriacases. Theriskfactors forfunguriain our series wereessentially old age, admission tointensive care unit, and broad-spectrum antibiotic therapy.
Conclusion:The current level of knowledge about the clinical situations leading to funguria with the improvement and popularization of efficient identification techniques for yeasts other than C. albicans should redress the epidemiology of funguria.This should allow the knowledgeable societies to establish the rules of interpreting the cytobacteriological examination of the urine in case of funguria, as for bacteriuria.
Disseminated cryptococcosis is a rare fungal infection, which mainly occurs in immunocompromised patients, and the diagnosis is difficult. Therefore, it is less likely to be considered in immunocompetent patients. Here, we present a case of fatal cryptococcal infection of the pleural fluid and ascites in a patient seronegative for HIV. The patient was a 45-year old man who was followed for Crohn's disease and treated with steroids and an immunosuppressant (azathioprine). The culture of pleural and ascites fluids showed the presence of yeasts colonies identified as Cryptococcus neoformans. Bacteriological examination of the blood culture or cerebrospinal fluid (CSF) was not prescribed. The HIV serology was negative. At the fourth day of treatment, the patient died because of the deterioration of neurological and hepatocellular functions. The main diagnostic problems that led to this fatal outcome were non-suspicion of an at-risk patient, lack of microbiological analysis of the blood or CSF, and inadequate antifungal therapy.
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