Overview
Candida ureteritis is an infectious condition characterized by Candida species infection of the ureter, often complicating urinary tract infections or existing candidal foci 12.Diagnosis
Clinical symptoms include flank pain, fever, and signs of systemic infection 12.
Urinalysis typically shows pyuria and leukocytosis 12.
Urine cultures are essential for identifying Candida species 12.
Imaging studies (e.g., ultrasound, CT urography) may reveal hydroureter or hydronephrosis 12.
Histopathological examination of ureteric biopsy material can confirm Candida presence 12.Management
First-line treatment: Intravenous echinocandins (e.g., caspofungin) are recommended for severe cases 12.
Adjunctive therapy: Oral fluconazole can be used for less severe or maintenance therapy 12.
Duration: Treatment duration varies but typically lasts 2-4 weeks, depending on response and imaging findings 12.
Source control: Ensure removal of any indwelling catheters or stones contributing to infection persistence 12.Special Populations
Pregnancy: Limited data; echinocandins are generally considered safe but require careful monitoring 12.
Pediatrics: Specific dosing and safety data are scarce; consult pediatric infectious disease specialists 12.
Elderly: Consider potential drug interactions and renal function adjustments in dosing 12.
Comorbidities: Patients with immunosuppression or underlying renal disease may require prolonged therapy and closer monitoring 12.Key Recommendations
Utilize urine cultures for definitive diagnosis of Candida ureteritis (Evidence: Moderate) 12.
Initiate intravenous echinocandins for severe cases of Candida ureteritis (Evidence: Moderate) 12.
Consider oral fluconazole for maintenance therapy in less severe cases (Evidence: Moderate) 12.
Ensure removal of potential sources of infection such as ureteral stents or calculi (Evidence: Expert opinion) 12.
Monitor closely in special populations including pregnant women, children, and the elderly due to unique considerations (Evidence: Expert opinion) 12.References
1 Larsen RG, Schultis KE, Van Leeuwen BJ, Deibert CM. Money Talks: The Shifting Effect of Limiting Monetary Incentives for Urology Resident Research. Urology 2024. link
2 Larsen RG, Bowdino CS, Van Leeuwen BJ, LaGrange CA, Deibert CM. The Positive Effect of Monetary Incentive on Urology Resident Research. Urology 2020. link