PREDISPOSING FACTORS OF SYSTEMIC FUNGAL-INFECTIONS OF THE GENITOURINARY TRACT

We reviewed 50 patients with genitourinary fungal infections between 1 982 and 1992. Infections were classified as simple-localized to the bl adder and complex-demonstrated evidence of upper tract and/or systemic infection. Predisposing factors of fungal infections, including diabe tes mellitus, prolonged Foley catheter drainage and corticosteroid use , were not significantly different. The incidences of obstructive urop athy (88% versus 20%), malnutrition (88% versus 48%), neoplasia (56% v ersus 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 infecti ons was 81% with an associated mortality rate of 36%. Of the patients with complex infections 56% required urological intervention. Given th e high incidence of obstructive uropathy with complex fungal infection s, upper tract imaging is essential.