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Emphysematous pyelonephritis caused by Candida infection
M D Kamaliah1, M Anita Bhajan, G A Abu Dzarr
1Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. kamalia@kb.usm.my
Summary
A rare case of fungal emphysematous pyelonephritis (EPN) in a diabetic patient caused by Candida albicans was successfully treated with nephrectomy. This highlights a unique fungal etiology for EPN, requiring aggressive management.
Area of Science:
- Nephrology
- Mycology
- Infectious Diseases
Background:
- Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of the kidney, typically associated with diabetes mellitus.
- While bacterial pathogens are common, fungal causes of EPN are exceptionally rare.
Observation:
- A diabetic patient presented with extensive unilateral EPN, diagnosed via computed tomography (CT) scan.
- Urine cultures exclusively identified Candida albicans, with no other microbial growth detected.
Findings:
- The patient's condition did not improve with broad-spectrum antibiotics and antifungal therapy.
- Surgical intervention in the form of nephrectomy led to a favorable clinical outcome.
Implications:
- This case underscores the possibility of fungal infections, specifically Candida albicans, as a cause of EPN.
- Aggressive management, including surgical intervention like nephrectomy, may be necessary for refractory cases of fungal EPN.