Fungal urinary tract infection is uncommon but carry a risk of progression to fungemia, which can be life-threatening. Diagnosis is challenging due to diverse clinical presentations and frequent misdiagnosis as urinary tract infections.

We report retrospectively two clinical cases of fungal urinary tract infection and provide a current literature review to assist urologists in clinical decision-making.

The clinical and laboratory characteristics of the two cases are detailed in Table 1. Several risk factors for urinary tract fungal infections have been identified and are listed in Table 2. The two clinical cases also present predisposing factors for urinary tract fungal infections. Both cases involved mixed infections with fungi and ESBL-producing bacteria, complicating treatment. Combined antifungal (Fluconazole) and antibiotic therapy showed good response. IDSA guidelines recommend Fluconazole as first-line treatment for symptomatic urinary fungal infections, with a treatment duration of at least 2 weeks (Table 3).

Early identification of risk factors for fungal urinary tract infection, exclusion of external contamination or colonization, and careful consideration of the clinical progression are critical for accurate diagnosis and management of fungal urinary tract infection.