The clinical significance of candidal casts.

Examination of the urinary sediment for fungal casts is a new and simple approach for assessing renal involvement in fungal infections. Identification of candidal casts was used to diagnose renal fungal involvement in five immunocompromised patients. In three cases, the examination of the urinary sediment permitted the diagnosis of early and presumably noninvasive renal candidal infections that cleared easily with relatively low doses of antifungal therapy. In two other cases, the recognition of candidal casts confirmed renal involvement in patients with disseminated disease.