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Candiduria — SCE Infectious Diseases MCQ

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EasyHealthcare-Associated InfectionsCandiduriaSCE Infectious Diseases

A 68-year-old man with an indwelling urinary catheter develops fever and rigors. Urine culture grows Candida albicans >10⁵ CFU/mL. Blood cultures are negative. He is haemodynamically stable and not neutropenic. What is the most appropriate management?

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Correct answer: B — Remove or replace urinary catheter and observe

Candiduria in a catheterised, stable, non-neutropenic patient is most commonly colonisation. The most appropriate first step is catheter removal or replacement. Antifungal treatment is not indicated for asymptomatic candiduria except in specific high-risk groups (neutropenic patients, renal transplant recipients, patients undergoing urological procedures). If symptoms persist after catheter management, Fluconazole is the treatment of choice. Bladder washouts with Amphotericin B are no longer recommended.

Reference: IDSA 2016 – Candidiasis guidelines; NICE 2023 – Catheter-associated UTI