The outcome of candiduria in pediatric patients.

The presence of Candida in the urine of a seriously ill, pediatric patient presents a management problem because of a lack of information concerning the natural history of candiduria and its relationship to disseminated candidiasis. In this retrospective study, the outcome of candiduria was examined in a group of 54 pediatric patients to determine any predictors of disseminated candidiasis. Medical records were reviewed to identify urine collection methods, Candida colony counts, results of cultures from other body sites, antifungal therapy, and clinical course. Six (11%) of the 54 patients had evidence of systematic Candida infection. In only two of these patients was candiduria the first evidence of disseminated candidiasis. Invasive infection was associated with candiduria more frequently in neonates and patients with central venous catheters and/or immunosuppressive therapy. Urine colony counts were not helpful for assessing the risk of invasive disease. Candiduria appears to be of little consequence in patients who are generally healthy. However, candiduria in high-risk patients, even in the presence of perineal candidal infection or an indwelling urinary catheter, should prompt a careful evaluation for disseminated infection.