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Isolated Renal Mucormycosis in Immunocompetent Hosts: Clinical Spectrum and Management Approach

Sudheer K Devana1, Vijayanth G Gupta1, Ravimohan S Mavuduru1

  • 1Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

The American Journal of Tropical Medicine and Hygiene
|January 18, 2019
PubMed

Insights

Isolated renal mucormycosis is a rare fungal infection affecting immunocompetent individuals. Early diagnosis and antifungal treatment before surgery improve survival rates for this emerging condition.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Radiology

Background:

  • Isolated renal mucormycosis is uncommon, particularly in immunocompetent individuals.
  • This study presents the largest case series to date on this rare entity.

Purpose of the Study:

  • To describe the clinical and radiological characteristics of isolated renal mucormycosis in immunocompetent hosts.
  • To evaluate treatment outcomes and identify factors influencing survival.

Main Methods:

  • Retrospective review of 15 cases of isolated renal mucormycosis in immunocompetent patients (March 2012 - June 2017).
  • Analysis of contrast-enhanced computed tomography (CT) scan findings.
  • Review of treatment modalities including nephrectomy and antifungal therapy.

Main Results:

  • All patients exhibited characteristic CT findings: enlarged kidneys, patchy enhancement, perinephric stranding, and thickened Gerota's fascia.
  • Nephrectomy was performed in 10/15 unilateral and 2/4 bilateral cases.
  • Mortality rate was 40% (6/15), with 2 patients treated with antifungals alone.

Conclusions:

  • Isolated renal mucormycosis is an emerging entity in healthy hosts.
  • Prompt diagnosis using characteristic imaging and early high-dose antifungal therapy, ideally before surgical intervention, are crucial for improving patient survival.

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