Study of antibody-coated fungi in patients with funguria and suspected disseminated fungal infections or primary fungal pyelonephritis.

The direct immunofluorescence method for the detection of antibody-coated bacteria in urine sediments has been used by investigators to distinguish invasive bacterial disease of the renal parenchyma from noninvasive bladder bacteriuria. The purpose of the present investigation was to test the usefulness of the demonstration of urinary fungal immunoglobulins and complement in distinguishing patients with fungal cystitis from those with suspected disseminated fungal disease. Twenty-one patients with microscopic funguria were suspected clinically of having disseminated fungal infection. Urine specimens from these patients were tested for the presence of antibody- and complement-coated fungi by direct immunofluorescence with the use of specific goat antisera to human immunoglobulins and complement. No unexpected frequencies of combinations of urinary yeast staining by specific antibody were noted. Urine specimens demonstrating funguria from 12 patients with uncomplicated illnesses were also examined for the presence of antibody- and complement-coated fungi; no unexpected frequencies of combinations of urinary yeast staining were noted in this group and no differences in frequencies of specific antibody staining were noted when compared with results in patients with suspected invasive fungal disease. Thus, no difference in the occurrence of specific antibody or complement adsorbed to urinary yeasts was observed between patients suspected of having invasive fungal disease and a small group of control patients.