Urinary-tract moniliasis consequent to broad-spectrum-antibiotic therapy has been occurring with increasing frequency. Two cases of chronic monilial cystitis, confirmed by fungus colony counts, were treated with bladder instillations of amphotericin B with dramatic clinical response. Fifteen milligrams of amphotericin B was instilled into the bladder once daily. Clinical improvement occurred after a few instillations. The diagnosis must be confirmed by serial dilution cultures, as most ordinary positive cultures will be due to contaminant growth. The presence of over 1,000 fungus colonies per milliliter of urine indicates significant clinical infection. This entity is not common but should be considered in all cases of obscure urinary-tract infection that are unresponsive to usual therapy.
Goldman HJ, Littman ML, Oppenheimer GD, Glickman SI. Monilial Cystitis—Effective Treatment with Instillations of Amphotericin B. JAMA. 1960;174(4):359–362. doi:10.1001/jama.1960.03030040013004
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