Abstract
Fungi are pathogenic agents that can also cause disseminated infections involving the kidneys. Besides Candida, other agents like Cryptococcus spp. can cause urinary tract infection (UTI), as well as other non-yeast fungi, especially among immunocompromised patients. The detection and identification of fungi in urine samples (by microscopy and culture) plays an essential role in the diagnosis of fungal UTI. However, variable cutoff definitions and unreliable culture techniques may skew analysis of the incidence and outcome of candiduria. The sediment analysis plays a key role in the identification of fungal UTI because both yeasts and pseudohyphae are easily identified and can be used as a clinical sign of fungal UTI but should not be overinterpreted. Indeed, urine markers of the immune response (leukocytes), urine barriers of tissue protection (epithelial cells), and urine markers of kidney disease (urinary casts) can be found in urine samples. This work explores the manifestations associated with the fungal UTI from the urinalysis perspective, namely the urinary findings and clinical picture of patients with fungal UTI caused by Candida spp., aspects associated with the immune response, and the future perspectives of urinalysis in the diagnosis of this clinical condition.
Highlights
Fungal urinary tract infection usually means urinary tract infection (UTI) caused by Candida species with special attention to Candida albicans as the major fungal infectious agent [1]
This work explains the urinary findings and clinical picture of patients with fungal UTI caused by Candida spp. and some aspects related to the immune response in fungal UTI, in addition to urinalysis perspectives in this clinical condition
This review focused on the urine sediment analysis a test that strongly contributes to the detection of fungal UTI, because both yeasts and pseudohyphae are identified on direct examination of the sample between slide and cover slide [3,4]
Summary
Fungal urinary tract infection usually means urinary tract infection (UTI) caused by Candida species with special attention to Candida albicans as the major fungal infectious agent [1]. Fungi are pathogenic agents that can cause disseminated infections involving the kidneys. Besides Candida, other agents, such as Cryptococcus spp., can cause UTIs. Non-yeast fungi, like some members of the Aspergillus, Mucorales, Blastomyces, and Histoplasma families, can cause infections, especially among immunocompromised patients [2]. Leukocyturia is a cardinal sign of UTI caused both by bacteria or fungi [3,4] and is a key sign of the immune response occurring in the urinary tract when the organism faces an UTI. This work explains the urinary findings and clinical picture of patients with fungal UTI caused by Candida spp. and some aspects related to the immune response in fungal UTI, in addition to urinalysis perspectives in this clinical condition
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