Candidal renal and urinary tract infection in neonates

Candida species are a common cause of urinary tract infection in newborns requiring intensive care. Renal candidiasis is frequently associated with these urinary tract infections and is manifest by “fungus balls” or renal parenchymal infiltration. Candidal urinary tract infections in high-risk newborns are often associated with candidemia, thereby warranting systemic antifungal therapy. Sonography is useful in diagnosing renal candidiasis, obstruction from “fungus balls,” and abscesses. The sonographic appearance of “fungus balls” may persist long after clinical resolution of Candida infection in neonates and should not affect duration of antifungal therapy. Amphotericin B is currently the drug of choice for neonates with renal candidiasis and candidal urinary tract infection. Surgical management should be reserved for decompression of obstructive candidiasis and drainage of abscesses.