Renal candidiasis in neonates with candiduria

Abstract

Serial renal ultrasounds are required to reliably detect late appearing renal fungus balls in neonates with candiduria. Complications requiring surgical intervention, like urinary tract obstruction, were uncommon.

Low Yield of Ancillary Diagnostic Studies in Neonates Infected with Candida

“…This may reflect a lack of consensus on the need for obtaining this ancillary test as well as the definition of a ''positive'' finding. Previous reports demonstrated a 42% incidence of renal fungal involvement in a population of 41 infants with candiduria, 17 but other series have reported the incidence of abnormal RUS findings to be more consistent with our own at 4.6% 23 and 7.1%. 7 Irrespective of the incidence of fungal infiltration in the kidney, the therapeutic dilemma posed by abnormal RUS findings in the setting of normal renal function and negative repeat cultures remains.…”

“…This finding suggests that serial brain imaging may be valuable in cases of persistent candidemia, as others have described for RUS imaging. 17,31 Ophthalmologic involvement in neonates with candidemia has been reported in 0% 7,24 to 6% 23 of patients who underwent examinations. These cases demonstrate the importance of ophthalmologic examination in neonatal candidiasis, but currently available data are restricted primarily to clinical series, thus firm recommendations regarding timing of the examination cannot be made.…”

“…There have been reports of neonates with candidal lens and retinal involvement, [10][11][12][13][14] but information regarding the incidences and natural history of candidal renal mycetoma, fungal endocarditis, and fungal brain abscesses among neonates is limited. [15][16][17][18][19][20][21][22][23][24] Ancillary testing including retinal examination, abdominal ultrasound and echocardiogram for all infants with candidemia has been suggested. 23 However, due to the uncertainty regarding the occurrence and severity of morbidities associated with invasive candidiasis, there is no consensus regarding the approach to ancillary diagnostic testing for infants with a positive blood, urine or CSF culture for a Candida species.…”

Nosocomial Candiduria in Critically Ill Patients Admitted to Intensive Care Units in Qazvin, Iran

“…In the present study, the frequency of candiduria was higher among children than adults (62% vs 25.4%, P = 0.001) (Table 1). Bryant et al (1999) (32) upon conducting a 12-year study in the large tertiary care neonatal ICUs in the USA, established the overall incidence of candiduria to be 0.5%. In contrast, another study in the USA (33) demonstrated a greater prevalence of Candida species causing UTI in 42% of patients.…”

Obstructive Renal Failure Caused by Bilateral Renal Candidiasis and Hypoplastic Renal Pelvises in a Preterm Infant: Case Presentation and Review of the Literature

“…When a Candidal urinary tract infection (UTI) is diagnosed in a neonate, it is important to assess the patient for candidemia. Phillips and Karlowicz found candidemia in 13 of 25 Candidal UTIs in neonates and Bryant et al reported this condition in 12 of 36 cases (7,8). Renal involvement in neonatal candidemia varies from 5% to 33% (9-11).…”