Candida infects native cardiac valves in IV drug users and patients receiving parentral nutrition. It may also occur following open heart surgeries. C. parapsilosis is the most common cause of endocarditis. Development of microabscesses invading the cardiac conduction system results in a complete heart block. It is important to note that negative blood cultures do not rule out the possibility of Candida endocarditis.
Renal candidiasis is hematogenous and originate from gastrointestinal tract.
Major risk factors for fungal UTI include the presence of foreign material in the urinary tract such as stents or stomal tubes, mechanical obstruction to the urine flow and renal transplantation. Candida can cause perinephric abscesses that may erode into the renal tubules, damage the renal cortex and cause tubular obstruction. The extension of fungi can turn into a fungus ball within the renal pelvis or ureters and lead to an obstruction and hydronephrosis. This may result in pyelonephritis with secondary fungemia and sepsis. Dissemination of fungi usually occurs with instrumentation of an immune suppressed or diabetic patient.