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

Devana, Sudheer Kumar; Gupta, Vijayanth G.; Mavuduru, Ravimohan; Bora, Girdhar S.; Sharma, Aditya; Parmar, Kalpesh; Kumar, Santosh; Mete, Uttam; Singh, Shrawan Kumar; Mandal, Arup Kumar; Kakkar, Nandita; Banerjee, Nirmalya; Ghosh, Anup

doi:10.4269/ajtmh.18-0103

Cited by 23 publications

(35 citation statements)

References 14 publications

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“…Contaminated intramuscular injections and surgery, adhesive tapes, and endobronchial tubes were sources of infection in nosocomial mucormycosis [ 16 , 22 , 36 , 37 ]. Isolated renal mucormycosis in an immunocompetent host is an emerging entity in India; the pathogenesis of the disease is still not known [ 38 , 39 ].…”

Section: Underlying Disease and Risk Factorsmentioning

confidence: 99%

“…Prakash et al reported haemodialysis and CKD as significant risk factors in renal mucormycosis patients [ 5 ]. Isolated renal mucormycosis can affect unilateral or bilateral kidneys [ 38 , 39 ]. Patients present with fever, flank pain, haematuria or dysuria, acute kidney injury, and white flakes in urine [ 38 , 39 ].…”

Section: Clinical Forms Of Mucormycosismentioning

confidence: 99%

“…Isolated renal mucormycosis can affect unilateral or bilateral kidneys [ 38 , 39 ]. Patients present with fever, flank pain, haematuria or dysuria, acute kidney injury, and white flakes in urine [ 38 , 39 ]. Computed tomography (CT) or ultrasound may help in achieving an early diagnosis of renal mucormycosis.…”

Section: Clinical Forms Of Mucormycosismentioning

confidence: 99%

“…Computed tomography (CT) or ultrasound may help in achieving an early diagnosis of renal mucormycosis. Enlarged kidneys with or without hypodensities, perinephric stranding, and thickened Gerota’s fascia are classical imaging findings in these group of patients [ 38 , 39 ].…”

Section: Clinical Forms Of Mucormycosismentioning

confidence: 99%

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Epidemiology of Mucormycosis in India

2021

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Mucormycosis is an angioinvasive disease caused by saprophytic fungi of the order Mucorales. The exact incidence of mucormycosis in India is unknown due to the lack of population-based studies. The estimated prevalence of mucormycosis is around 70 times higher in India than that in global data. Diabetes mellitus is the most common risk factor, followed by haematological malignancy and solid-organ transplant. Patients with postpulmonary tuberculosis and chronic kidney disease are at additional risk of developing mucormycosis in this country. Trauma is a risk factor for cutaneous mucormycosis. Isolated renal mucormycosis in an immunocompetent host is a unique entity in India. Though Rhizopus arrhizus is the most common etiological agent of mucormycosis in this country, infections due to Rhizopus microsporus, Rhizopus homothallicus, and Apophysomyces variabilis are rising. Occasionally, Saksenaea erythrospora, Mucor irregularis, and Thamnostylum lucknowense are isolated. Though awareness of the disease has increased among treating physicians, disease-associated morbidity and mortality are still high, as patients seek medical attention late in the disease process and given the low affordability for therapy. In conclusion, the rise in the number of cases, the emergence of new risk factors and causative agents, and the challenges in managing the disease are important concerns with mucormycosis in India.

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Section: Underlying Disease and Risk Factorsmentioning

confidence: 99%

Section: Clinical Forms Of Mucormycosismentioning

confidence: 99%

Section: Clinical Forms Of Mucormycosismentioning

confidence: 99%

Section: Clinical Forms Of Mucormycosismentioning

confidence: 99%

See 2 more Smart Citations

Epidemiology of Mucormycosis in India

2021

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“…1 These infections are opportunistic and are mainly noted in individuals with compromised immunity although of late few cases in immunocompetent individuals have also been reported. [2][3][4]…”

Section: Introductionmentioning

confidence: 99%

Isolated renal mucormycosis: a rarity

Sandhu

Jha

2020

Int Surg J

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Mucormycosis is a rare, opportunistic, highly aggressive, fungal infection primarily noted in immunocompromised individuals. Isolated involvement of any organ is rare in general. Isolated renal involvement is unusual, with only a few cases reported in literature to date. We present a rare case of isolated renal mucormycosis successfully managed with systemic anti-fungal therapy and nephron sparing surgery.

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Unilateral renal mucormycosis in a patient presenting with pyelonephritis and acute kidney failure: A case report

Darouei,

Zare,

Torkashvan

et al. 2024

Clinical Case Reports

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Key Clinical MessageUnilateral renal mucormycosis is a rare infection that should be suspected in patients with recurrent renal infections presenting nonspecific clinical features that do not respond to conventional therapies, especially in impaired immune systems due to related risk factors. Moreover, histopathological examinations should be performed to confirm the diagnosis. For treatment, the preference is that the patient is hospitalized, and surgical intervention and rapid administration of intravenous antifungals for 2–3 weeks are the treatment choices. After discharge, the patient should be followed up with periodic blood urea nitrogen and creatinine levels and, if needed, an imaging modality such as a CT scan or sonography.AbstractRenal mucormycosis (RM) is a rare form of mucormycosis infection and is more often in immunocompromised patients with risk factors. Unilateral renal involvement is infrequent in patients and is available as case reports. This condition usually presents with renal colic, fever and chills, and oliguria and has a high mortality rate. Herein, we report a case of unilateral renal mucormycosis presenting with pyelonephritis and acute kidney injury in a 32‐year‐old patient. The patient had numerous urological procedures in previous years due to nephrolithiasis state, which put him in an immunocompromised state. The histopathological examination of the pylocalyceal system revealed a collection of broad non‐septated fungal hyphae branching at 90° accompanied by numerous neutrophils and necrotic tissue in favor of mucormycosis. He was successfully treated with 5 mg/kg/day Liposomal Amphotericin B for 3 weeks, discharged with good general condition, and remained asymptomatic for 3 months after discharge. The diagnosis of RM relies on solid clinical suspicion, which can be authenticated by histopathological examination, and the combination of antifungal therapy and surgical intervention can result in a good outcome.

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

Cited by 23 publications

References 14 publications

Epidemiology of Mucormycosis in India

Epidemiology of Mucormycosis in India

Isolated renal mucormycosis: a rarity

Unilateral renal mucormycosis in a patient presenting with pyelonephritis and acute kidney failure: A case report

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