Candida-Associated Renal Papillary Necrosis Following Severe COVID-19 Infection

Candida-associated renal papillary necrosis is rare. The few cases described previously were secondary to candidemia, especially in immunocompromised hosts. We describe two patients who presented with hydroureteronephrosis and were diagnosed with candida-associated renal papillary necrosis. Both patients had a history of severe COVID-19 infection within the past year and had been treated with immunosuppressants. Both patients underwent double J stenting and anti-fungal treatment with fluconazole. One patient recovered completely, while the other patient who had chronic kidney disease stage 4 at diagnosis progressed to dialysis-dependent renal failure later following an episode of bacterial sepsis. The incidence of candida-associated renal papillary necrosis may reflect the immunomodulatory effects of COVID-19, immunosuppressants, or a combination of both.