Skip to main content
SpringerLink
Log in

Unexpected candidemia complicating ureteroscopy and urinary stenting

  • Note
  • Published:
European Journal of Clinical Microbiology and Infectious Diseases Aims and scope Submit manuscript

Abstract

Two elderly patients with obstructive renal calculi who developedCandida albicans bloodstream infection within 12 h following ureteroscopy and ureteral stenting are described. Both patients were treated with prolonged courses of broad-spectrum antibiotics and were found to have urine cultures positive forCandida albicans prior to the urologic procedures. One patient also developed bilateral candidal endophthalmitis. The clinical presentation was indistinguishable from bacteremia complicating manipulation of the urinary tract. The patients were successfully treated with systemic antifungal therapy. Candiduria may present a risk for dissemination during invasive, relatively simple urologic procedures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Béck-Sague CM, Jarvis WR, the National Nosocomial Infection Surveillance System: Secular trends in the epidemiology of nosocomial fungal infections in the United States, 1980–1990. Journal of Infectious Diseases (1993) 167:1247–1251

    Google Scholar 

  2. Fridkin SK, Jarvis WR: Epidemiology of nosocomial fungal infections. Clinical Microbiology Reviews (1996) 9:499–511

    Google Scholar 

  3. Jarvis WR: Epidemiology of nosocomial fungal infections, with emphasis onCandida species. Clinical Infectious Diseases (1995) 20:1526–1530

    Google Scholar 

  4. Bross J, Talbot GH, Maislin G, Hurwitz S, Storm BL: Risk factors for nosocomial candidemia: a case-control study in adults without leukemia. American Journal of Medicine (1989) 87:614–619

    Google Scholar 

  5. Goodrich JM, Reed EC, Skerrett S, Mori M, Fisher LD, Dandliker PS, Kils B, Counts GW, Meyers JD: Clinical features and analysis of risk factors for invasive candidal infection after marrow transplantation. Journal of Infectious Diseases (1991) 164:731–740

    Google Scholar 

  6. Karabinis A, Hill C, Leclercq B, Tancréde C, Baume D. Andremont A: Risk factors for candidemia in cancer patients: a case-control study. Journal of Clinical Microbiology (1988) 26:429–432

    Google Scholar 

  7. Richet HM, Andremont A, Tancréde C, Pico JL, Jarvis WR: Risk factors for candidemia in patients with acute lymphocytic leukemia. Reviews of Infectious Diseases (1991) 13:211–215

    Google Scholar 

  8. Weese-Mayer DE, Wheeler Fondriest D, Brouillette RT, Shulman ST: Risk factors associated with candidemia in the neonatal intensive care unit: a case-control study. Pediatric Infectious Disease Journal (1987) 6:190–196

    Google Scholar 

  9. Wenzel RP: Nosocomial candidemia: risk factors and attributable mortality. Clinical Infectious Diseases (1995) 20:1531–1534

    Google Scholar 

  10. Wey SB, Mori M, Pfaller MA, Woolson RF, Wenzel RP: Risk factors for hospital-acquired candidemia. A matched casecontrol study. Archives of Internal Medicine (1988) 149:2349–2353

    Google Scholar 

  11. Nieto-Rodriguez JA, Kusne S, Maňez R, Irish W, Linden P, Mangone M, Wing EJ, Fung JJ, Starzl TE: Factors associated with the development of candidemia and candidemia-related death among liver transplant recipients. Annals of Surgery (1996) 223:70–76

    Google Scholar 

  12. Carson CCI: Endourology. In: Glenn JF (ed): Urologic surgery. J.B. Lippincott, Philadelphia (1991) pp. 287–305

    Google Scholar 

  13. Saltzman B: Ureteral stents. Indication, variation, and complications. Urologic Clinics of North America (1988) 15:481–491

    Google Scholar 

  14. Sullivan NM, Sutter VL, Mims MM, Marsh VH, Finegold SM: Clinical aspects of bacteremia after manipulation of the genitourinary tract. Journal of Infectious Diseases (1973) 127:49–55

    Google Scholar 

  15. Donahue SP, Greven CM, Zuravleff JJ, Eller AW, Nguyen MH, Peacock JEJ, Wagener MW, Yu VL: Intraocular candidiasis in patients with candidemia. Clinical implications derived from a prospective multicenter study. Ophthalmology (1994) 101:1302–1309

    Google Scholar 

  16. Nolla-Salas J, Sitges-Serra A, Leon C, de la Torre MV, Sancho H:Candida endophthalmitis in non-neutropenic critically ill patients. European Journal of Clinical Microbiology & Infectious Diseases (1996) 15:503–506

    Google Scholar 

  17. O'Day DM, Foulds G, Williams TE, Robinson RD, Allen RH, Head WS: Ocular uptake of fluconazole following oral administration. Archives of Ophthalmology (1990) 108:1006–1008

    Google Scholar 

  18. Akler ME, Vellend H, McNeely DM, Walmsley SL, Gold WL: Use of fluconazole in the treatment of candidal endophthalmitis. Clinical Infectious Diseases (1995) 20:657–664

    Google Scholar 

  19. Park SS, D'Amico DJ, Paton B, Baker AS: Treatment of exogenousCandida endophthalmitis in rabbits with oral fluconazole. Antimicrobial Agents and Chemotherapy (1995) 39:958–963

    Google Scholar 

  20. Luttrull JK, Wan WL, Kubak BM, Smith MD, Oster HA: Treatment of ocular fungal infections with oral fluconazole. American Journal of Ophthalmology (1995) 119:477–481

    Google Scholar 

  21. del Palacio A, Cuetara MS, Ferro M, Perez-Blazquez E, Lopez-Sana JA, Roiz M, Carnevali D, Noriega AR: Fluconazole in the management of endophthalmitis in disseminated candidosis of heroin addicts. Mycoses (1993) 36:193–199

    Google Scholar 

  22. Edwards JEJ, Bodey GP, Bowden RA, Buchner T, de Pauw BE, Filler SG, Ghannoum MA, Glauser M, Herbrecht R, Kauffman CA, Kohno S, Martino P, Meunier F, Mori T, Pfaller MA, Rex JH, Rogers TR, Rubin RH, Solomkin J, Viscoli C, Walsh TJ: International Conference for the Development of a Consensus on the Management and Prevention of Severe Candidal Infections. Clinical Infectious Diseases (1997) 25:43–59

    Google Scholar 

  23. Nomura J, Ruskin J: Failure of therapy with fluconazole for candidal endophthalmitis. Clinical Infectious Diseases (1993) 17:888–889

    Google Scholar 

  24. Claes-Goran B, Goran G:125I Hippuran absorption from the human renal pelvis. Journal of Urology (1986) 136:726–732

    Google Scholar 

  25. Sonda PL, Fischer PC, Gross MD, Skiner RS: Pyelovenous backflow: implications for coagulium pyelolythotomy and nephroscopy. Journal of Urology (1985) 133:894–896

    Google Scholar 

  26. Ryan PC, Lennon GM, McLean PA, Fitzpatrick JM: The effect of acute and chronic JJ stent placement on upper urinary tract motility and calculus transit. British Journal of Urolosy (1994) 74:434–439

    Google Scholar 

  27. Ang BSP, Teleni A, King B, Steckelberg JM, Wilson WR: Candidemia from a urinary tract source: microbiological aspects and clinical significance. Clinical Infectious Diseases (1992) 17:662–666

    Google Scholar 

  28. Nicholson ML, Veitek PS, Donnelley PK, Bell PRF: Systemic candidiasis caused by a renal transplant ureteric stent. British Journal of Urology (1992) 70:448–449

    Google Scholar 

  29. Wong-Beringer A Jacobs RA, Guglielmo BJ: Treatment of funguria. Journal of the American Medical Association (1992) 267:2780–2785

    Google Scholar 

  30. Gubbins PO, Piscitelli SC, Danziger LH: Candidal urinary tract infections: a comprehensive review of their diagnosis and management. Pharmacotherapy (1993) 13:110–127

    Google Scholar 

  31. Gubbins PO, Ochipinti DJ, Danziger LH: Surveillance of treated and untreated funguria in a university hospital. Pharmacotherapy (1994) 14:463–470

    Google Scholar 

  32. Goldberg PK, Koznin PJ, Wise GJ, Nouri N, Brooks RB: Incidence and significance of candiduria. Journal of the American Medical Association (1979) 241:582–584

    Google Scholar 

  33. Seneca H, Peer P: Clinical laboratory diagnosis of urinary tract infection. Journal of Urology (1965) 94:78–81

    Google Scholar 

  34. Anonymous: Urinary tract candidosis. Lancet (1988) 2:1000–1002

  35. Nassoura Z, Ivatury RR, Simon RJ, Jabbour N, Stahl WM: Candiduria as an early marker for disseminated infection in critically ill surgical patients: the role of fluconazole therapy. Journal of Trauma (1993) 35:290–295

    Google Scholar 

  36. Pittet D, Monod M, Suter PM, Frenk E, Aukenthaler R: Candida colonization and subsequent infection in critically ill surgical patients. Annals of Surgery (1994) 230:751–758

    Google Scholar 

  37. Jacobs LG, Skidmore EA, Freeman K, Lipschultz D, Fox N: Oral fluconazole compared with bladder irrigation with amphotericin B for treatment of fungal urinary tract infections in elderly patients. Clinical Infectious Diseases (1996) 22:30–35

    Google Scholar 

  38. Hsieh-Shong L, Ching-Tai H: Clearance of funguria with short-course antifungal regimens: a prospective randomized, controlled study. Clinical Infectious Diseases (1995) 20:1152–1157

    Google Scholar 

  39. Fan-Havard P, O'Donovan C, Smith SM, Oh J, Bamberger M, Eng RHK: Oral fluconazole versus amphotericin B bladder irrigation for treatment of candidal funguria. Clinical Infectious Diseases (1995) 21:960–965

    Google Scholar 

  40. Tacker JR: Successful use of fluconazole for treatment of urinary tract fungal infection. Journal of Urology (1992) 148:1917–1918

    Google Scholar 

  41. Fisher JF, Newman CL, Sobe! JD: Yeast in the urine: solutions for a budding problem. Clinical Infectious Diseases (1995) 20:183–189

    Google Scholar 

  42. Como JA, Dismukes WE: Oral azole drugs as systemic antifungal therapy. New England Journal of Medicine (1994) 330:263–272

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Rabin Medical Center, Beilinson Campus, 49100, Petah-Tikva, Israel

    M. Gross & H. Winkler

  2. Department of Internal Medicine C & Infectious Diseases, Rabin Medical Center, Beilinson Campus, 49100, Petah-Tikva, Israel

    S. Pitlik & M. Weinberger

Authors
  1. M. Gross
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Winkler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Pitlik
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Weinberger
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gross, M., Winkler, H., Pitlik, S. et al. Unexpected candidemia complicating ureteroscopy and urinary stenting. Eur. J. Clin. Microbiol. Infect. Dis. 17, 583–586 (1998). https://doi.org/10.1007/BF01708625

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01708625

Keywords

Search

Navigation