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Isolated renal mucormycosis masquerading as emphysematous pyelonephritis
Supradeep Narayanaswamy1, Rajvi Goradia2, Amit Bellurkar2
1Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India vidvathpriya@gmail.com.
Abstract:
Mucormycosis is an acute, life-threatening infection and isolated renal involvement is rare. Due to the angioinvasive nature of the disease, it is rapidly progressive and can be lethal if not managed expeditiously. In patients with underlying conditions of immunosuppression, diabetes mellitus, transplantation, COVID-19, intravenous drug and substance use and pyelonephritis, which is unable to be controlled via regular antibiotics, mucormycosis must be considered on the differential and antifungals must be empirically started. Most cases are often diagnosed on histopathology, which causes delayed treatment and resolution. We present a case of emphysematous pyelonephritis diagnosed on imaging and was later found to have mucormycosis on histopathological examination.
Insights
Mucormycosis, a rare but life-threatening fungal infection, can affect the kidneys. Early diagnosis and empirical antifungal treatment are crucial for patients with risk factors like diabetes or immunosuppression.
Area of Science:
- Infectious Diseases
- Nephrology
- Mycology
Background:
- Mucormycosis is an aggressive, life-threatening fungal infection.
- Isolated renal involvement is uncommon but critical.
- Prompt management is essential due to rapid progression.
Observation:
- The case involved emphysematous pyelonephritis, initially diagnosed via imaging.
- Histopathological examination confirmed mucormycosis as the underlying cause.
- This highlights a rare presentation of renal mucormycosis.
Findings:
- Emphysematous pyelonephritis can be a sign of renal mucormycosis.
- Histopathology is key for definitive diagnosis, though often delayed.
- Early consideration of mucormycosis in high-risk patients is vital.
Implications:
- Imaging findings of emphysematous pyelonephritis warrant consideration of mucormycosis.
- Empirical antifungal therapy should be initiated promptly in at-risk individuals.
- Improved diagnostic strategies are needed to reduce treatment delays.
Related Concept Videos
Acute Pyelonephritis I: Introduction
Acute Pyelonephritis II: Diagnostic Studies and Management
Urinary Tract Infection II: Pathophysiology
Nephrotic Syndrome I : Introduction
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Urinary Tract Infection I: Introduction

