Asymptomatic candiduria in adults

Asymptomatic candiduria (caused by Candida and related species) is common, particularly in adults with indwelling urinary catheters. Asymptomatic candiduria almost always represents colonisation and rarely leads to disseminated candidiasis. Pyuria in an adult with a urinary catheter or stent does not differentiate infection from colonisation.

Most adults with asymptomatic candiduria do not require antifungal therapy (systemic or local). Only patients with neutropenia or patients undergoing urological procedures require treatment, because they are at higher risk of developing disseminated candidiasis.

For adults with neutropenia and asymptomatic candiduria, treat as for symptomatic pyelonephritis caused by Candida and related speciesPappas, 2016. Adults undergoing urological procedures should also be treated with the regimen for symptomatic pyelonephritis caused by Candida and related species but for a shorter duration (several days before and after the procedure) – seek expert advice.

The risk of candiduria is increased by the continued use of urinary catheters, urinary stents or nephrostomy tubes – remove these devices if possible.