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Multifocal Renal Fungal Abscesses

Eric Y Cho1, Joshua R Kaplan1, Linda Mamone1

  • 1Department of Urology, Temple University School of Medicine, Philadelphia, PA.

Urology
|March 20, 2016
PubMed

Insights

This case study highlights a rare instance of multiple fungal renal abscesses in a patient with diabetes and a history of intravenous substance use. Surgical intervention was necessary when medical management failed, leading to patient recovery.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Mycology

Background:

  • Fungal renal abscesses are uncommon, particularly multifocal presentations.
  • Patients with diabetes and intravenous substance use disorder are at increased risk for invasive fungal infections.
  • Fungal fungemia can lead to disseminated disease, including renal involvement.

Observation:

  • A 36-year-old woman with diabetes and intravenous substance use disorder presented with fever and hematuria.
  • Blood cultures revealed bacteremia and fungemia.
  • Imaging demonstrated multiple fungal renal abscesses unresponsive to initial broad-spectrum antibiotic and antifungal therapy.

Findings:

  • Nephrectomy was performed due to persistent fever and lack of improvement in renal abscesses despite medical management.
  • Post-nephrectomy, the patient's fever resolved, and follow-up blood cultures were negative.
  • This case underscores the challenges in managing refractory multifocal fungal renal abscesses.

Implications:

  • Surgical intervention, such as nephrectomy, may be a necessary treatment option for multifocal fungal renal abscesses that do not respond to medical therapy.
  • Further research is needed to establish optimal management guidelines for this rare clinical presentation.
  • Early recognition and aggressive treatment are crucial for improving outcomes in patients with invasive fungal kidney infections.

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