The identification of fungal casts. A new method for diagnosing visceral candidiasis.

Visceral candidiasis is a potentially life-threatening infection that is difficult to diagnose clinically. Existing laboratory methods do not adequately distinguish visceral candidiasis from extensive candidal infections of mucosal surfaces. A new laboratory method, the detection of fungal casts in urine sediment, permits the unequivocal diagnosis of renal candidiasis. Since the severity of renal candidiasis varies, the clinical significance attributed to the identification of fungal casts in the urine must be based upon a complete assessment of the patient. The ultimate utility of the fungal cast method will depend upon the incidence with which fungal casts can be identified in the urine of patients with renal candidiasis. At present, this incidence is unknown. However, the method has been clinically useful in a number of specific cases and should not be overlooked in evaluating patients with candiduria in whom the diagnosis of visceral candidiasis is suspected but not confirmed.