Candidal urinary tract infection as a cause of pneumaturia

Colonization of the urinary tract by Candida species occurs particularly in diabetic or immunocompromised patients. We report the cases of two patients presenting with pneumaturia and urinary tract infection who were initially thought to have colovesical fistulae. In both patients a diagnosis of emphysematous pyelonephritis or cystitis due to candidal infection was subsequently made. These cases serve as a reminder of this rare presentation of a not uncommon urinary tract infection.