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Unexpected candidemia complicating ureteroscopy and urinary stenting
1Department of Urology, Rabin Medical Center, Beilinson Campus, Petah-Tikva, Israel.
Summary
Candiduria, or Candida in urine, can lead to bloodstream infections after urinary tract procedures. Early antifungal treatment is key for successful outcomes in at-risk patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Mycology
Background:
- Obstructive renal calculi necessitate urologic interventions like ureteroscopy and stenting.
- Elderly patients with urinary tract conditions may have increased susceptibility to infections.
- Prior candiduria can be a risk factor for systemic Candida infections.
Observation:
- Two elderly patients with obstructive renal calculi developed Candida albicans bloodstream infections within 12 hours post-ureteroscopy and stenting.
- Both patients had pre-existing candiduria and received prolonged broad-spectrum antibiotic treatment.
- One patient also experienced bilateral candidal endophthalmitis.
Findings:
- Candida albicans bloodstream infection following urologic procedures can mimic bacterial infections.
- Systemic antifungal therapy proved effective in treating these invasive candidal infections.
- Candiduria poses a significant risk for systemic dissemination during urologic interventions.
Implications:
- Healthcare providers should screen for and manage candiduria before urologic procedures in elderly patients.
- Awareness of candiduria as a risk factor can prevent severe complications like bloodstream infections and endophthalmitis.
- Minimally invasive urologic procedures require careful consideration of fungal infection risks in susceptible populations.