糖尿病患者における細菌性腎盂腎炎を呈した孤発性腎粘液真菌症の1例：症例報告

Isolated renal mucormycosis is a rare, aggressive fungal infection primarily affecting immunocompromised individuals. It often presents diagnostic challenges, mimicking bacterial infections like pyelonephritis. We report the case of a 45-year-old diabetic man presenting with flank pain and fever. Imaging suggested emphysematous pyelonephritis grade 3B. Initial treatment with broad-spectrum antibiotics failed, and blood and urine cultures remained sterile. Nephrectomy revealed angioinvasive mucormycosis. Despite antifungal therapy and nephrectomy, the patient succumbed to the infection. Our case highlights that renal mucormycosis can mimic bacterial pyelonephritis, delaying diagnosis. Clinicians should consider mucormycosis in diabetic patients with persistent symptoms and sterile cultures. Early surgical intervention and antifungal therapy are the mainstay.