Korean J Urol.  2013 Sep;54(9):641-643.

Isolated Renal Mucormycosis in a Healthy Immunocompetent Patient: Atypical Presentation and Course

Affiliations
  • 1Department of Urology, Sir Ganga Ram Hospital, New Delhi, India. drmrinalpahwa@gmail.com
  • 2Department of Pathology, Lady Harding Medical College, New Delhi, India.
  • 3John Hopkins Institute, Baltimore, MD, USA.
  • 4Department of Nephrology, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA.

Abstract

Isolated renal mucormycosis is rarely identified and has been described in only a handful of cases. We hereby report a case of isolated renal mucormycosis with an atypical presentation in an immunocompetent patient with no identifiable risk factors. A 30-year-old nondiabetic male presented with a poorly functioning right kidney with minimal constitutional symptoms. The patient underwent a right simple nephrectomy. Histopathology revealed necrotizing xanthogranulomatous pyelonephritis with mucormycosis. The postoperative period was uneventful and the patient was managed without any antifungal administration. We hereby emphasize that renal mucormycosis can affect immunocompetent healthy adults without any previously known risk factors and that asymptomatic patients with no evidence of fungemia or disseminated disease can be managed without administration of intravenous amphotericin.

Keyword

Amphotericin B; Immunocompetence; Mucormycosis; Urinary tract infection

MeSH Terms

Adult
Amphotericin B
Fungemia
Humans
Immunocompetence
Kidney
Male
Mucormycosis
Nephrectomy
Postoperative Period
Pyelonephritis, Xanthogranulomatous
Risk Factors
Urinary Tract Infections
Amphotericin B

Figure

  • FIG. 1 Computed tomographic scan showing a large heterogeneous mass involving the upper pole of the right kidney.

  • FIG. 2 Xanthogranulomatous pyelonephritis. Section showing numerous foamy histiocytes and few giant cells (H&E, ×40).

  • FIG. 3 Broad, aseptate hyphae with right angle branching in necrosed renal parenchyma (chromic acid silver methenamine stain, ×20).


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