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Urinary tract candidiasis
Medical expert of the article
Last reviewed: 12.07.2025
[ Symptoms urinary candidiasis
Candidal cystitis is characterized by frequent painful urination. Candidal pyelonephritis is characterized by pain in the lumbar region, increased body temperature and pain when urinating.
Diagnostics urinary candidiasis
Diagnosis of urinary tract candidiasis is based on the detection of Candida spp. in urine and assessment of the patient's condition. It is important to correctly understand the clinical significance of the detection of Candida spp. in urine. Most patients experience asymptomatic candiduria, indicating colonization of the lower urinary tract by Candida spp.; this circumstance is not considered an indication for the use of antimycotics (it is sufficient to eliminate or correct risk factors).
Candiduria in combination with clinical or instrumental signs of urinary tract infection is an indication for the use of antifungal drugs. In addition, urinary tract candidiasis can be a source, and candiduria can be a manifestation of invasive candidiasis. That is why, with a high risk of developing invasive candidiasis (the presence of risk factors, suspected clinical signs), additional examination and a decision on the appointment of antifungal therapy are indicated.
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Treatment urinary candidiasis
Treatment is performed in patients with clinical signs of urinary tract infection or asymptomatic candiduria and the presence of risk factors for the development of invasive candidiasis. Treatment of urinary tract candidiasis consists of the use of systemic antifungal agents, removal or replacement of urinary catheters, elimination or reduction of other risk factors (optimization of the use of antibacterial drugs, correction of diabetes mellitus, etc.). The drug of choice is fluconazole, unlike other antifungal agents, it creates a high concentration of the active substance in the urine. If fluconazole is ineffective, bladder lavage with amphotericin B solution (50-200 mcg/ml) is used, usually accompanied by a temporary cessation of candiduria, however, this treatment method is ineffective in case of damage to the upper urinary tract. If fluconazole is ineffective and there is possible damage to the renal parenchyma, caspofungin or voriconazole are used.
In asymptomatic candiduria in patients without risk factors for invasive candidiasis, antifungal drugs are not used. Elimination or reduction of risk factors for urinary tract candidiasis (removal or replacement of the urinary catheter, optimization of the use of antibacterial drugs, correction of diabetes mellitus, etc.) usually leads to the elimination of asymptomatic candiduria.