Predisposing factors of systemic fungal infections of the genitourinary tract.
We reviewed 50 patients with genitourinary fungal infections between 1982 and 1992. Infections were classified as simple--localized to the bladder and complex--demonstrated evidence of upper tract and/or systemic infection. Predisposing factors of fungal infections, including diabetes mellitus, prolonged Foley catheter drainage and corticosteroid use, were not significantly different. The incidence of obstructive uropathy (88% versus 20%), malnutrition (88% versus 48%), neoplasia (56% versus 16%), renal failure (24% versus 8%) and prolonged antibiotic use (60% versus 32%) were significantly greater in patients with complex infections. The incidence of fungemia in patients with complex infections was 81% with an associated mortality rate of 36%. Of the patients with complex infections 56% required urological intervention. Given the high incidence of obstructive uropathy with complex fungal infections, upper tract imaging is essential.
Wainstein
M A
MA
Department of Urology, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA.
Graham
R C
RC
Resnick
M I
MI
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002404:Catheterization / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy / Q000453:epidemiology*; D009748:Nutrition Disorders / Q000453:epidemiology; D009820:Ohio / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D001745:Urinary Bladder Diseases / Q000453:epidemiology / Q000382:microbiology; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology*; D014570:Urologic Diseases / Q000453:epidemiology; D014571:Urologic Neoplasms / Q000453:epidemiology
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents