Renal Mucormycosis: A Rare Cause of Urinary Tract Infection Leading to End-stage Renal Disease (ESRD)

Mathew, Georgie; Arumugam, Venkatesh; Murugesan, S Tirumalvalavan; Duhli, Neelaveni; Agarwal, Indira

doi:10.1093/tropej/fmy059

Cited by 6 publications

(7 citation statements)

References 6 publications

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“…Another patient was treated with deoxycholate amphotericin B (AMB), but he deteriorated further and he succumbed before surgery ( 46 ). In two other patients, surgery was considered by physicians for the management of RM; however, due to the patient's frail state as well as multiple comorbidities and parental opposition, the surgery was not applied to the patients ( 47 , 50 ).…”

Section: Resultsmentioning

confidence: 99%

Clinical presentations, diagnosis, management, and outcomes of renal mucormycosis: An overview of case reports

et al. 2022

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BackgroundRenal mucormycosis (RM) is a rare presentation of invasive mucormycosis with a high mortality rate. There is no single systematic review of the literature that indicates the different clinical aspects of RM.MethodsA systematic search of PubMed/Medline was performed to collect individual case reports of RM in patients of all ages published between 2010 and April 2022.ResultsSeventy-one individual cases were detected through PubMed bibliographic database searches, with a final assessment performed on 60 patients with RM. India and Asia had the largest number of reported cases, with 30 (50%) and 42 (70%) reports, respectively. Also, 74 and 26% of the patients with a mean age of 33 years were male and female, respectively. RM showed 44% mortality rate in the analyzed cases. Immunosuppressive agent therapy followed by tissue transplantation (kidney and liver) and diabetes were the most remarkable risk factors in patients. Nevertheless, 22% of the patients were immunocompetent with no apparent underlying condition. COVID-19 positivity was detected in eight adult patients with an 87% mortality rate. The most common signs of infection were fever, flank pain, and oliguria; additionally, isolated RM was reported in 57% of the cases. In 55% of the patients, histopathologic examination alone was sufficient to diagnose RM, whereas molecular methods and culture were used in only 18 and 35% of patients, respectively. Surgery alone, surgery plus anti-infection therapy, and anti-infection therapy alone were used in 12, 60, and 13% of patients, respectively. Furthermore, 15% of the patients died before any treatment.ConclusionThe early diagnosis of RM is necessary. In this regard, the use of molecular-based diagnostic assays can help identify the fungus at the genus and species levels and use an appropriate treatment in the shortest possible amount of time. Because of the increase in antibiotic resistance in recent years, determining microbial susceptibility tests can lead to the better infection management. Additionally, withdrawal of immunosuppressant, appropriate surgical intervention, and antifungal therapy are the main factors associated with a successful outcome in RM.

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Section: Resultsmentioning

confidence: 99%

Clinical presentations, diagnosis, management, and outcomes of renal mucormycosis: An overview of case reports

et al. 2022

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“…Fungi belonging to zygomycetes class are opportunistic organisms having the propensity to cause a fatal infection in immunocompromised states. [ 1 2 ] Within this taxonomic class lies Mucorales order, which encompasses fungi causing mucormycosis. [ 1 ] Common forms of mucormycosis include rhinocerebral, pulmonary, gastrointestinal, and disseminated.…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 ] Mathew et al . have suggested some unique property of the immune system in children might have contributed to this occurrence;[ 2 ] however, this hypothesis needs further evaluation before definite conclusions are drawn. Majority of the children presented with fever (11/13; 85%) and flank or abdominal pain (9/13; 69%).…”

Section: Discussionmentioning

confidence: 99%

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Isolated renal mucormycosis in children: A case report and review of the literature

Anand

Kainth

Dhua

et al. 2021

J Indian Assoc Pediatr Surg

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Isolated renal mucormycosis is rare in children. A case of 3-month-old infant presenting with right-sided flank lump and fever is being reported. Investigations revealed a nonfunctioning right kidney with intrarenal abscesses and a low percent-frequency of T-cells. He made an uneventful recovery following surgery and systemic antifungal therapy. Compared to the other forms of deep mucormycosis, a review of literature suggests favorable prognosis in children with isolated renal involvement.

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“…However, renal and gastrointestinal involvement has also been reported though rarely. 4 , 5 Here, we present a case series of 10 patients who were admitted to our adult ICU for mucormycosis management.…”

Section: Introductionmentioning

confidence: 99%

Mucormycosis: A Case Series of Patients Admitted in Non-COVID-19 Intensive Care Unit of a Tertiary Care Center during the Second Wave

Yadav¹,

Sharma²,

Kothari³

et al. 2022

Indian Journal of Critical Care Medicine

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A bstract Rhino-orbital-cerebral mucormycosis is an invasive fungal infection associated with mortality of 25–62%. There has been a surge in the number of cases during this second wave of coronavirus disease-2019 (COVID-19) in India. We report 10 cases of mucormycosis admitted to our adult intensive care unit. After reviewing the patient's information, we found that 60% of patients had received steroids, and most had uncontrolled blood sugar levels. Most patients received treatment with surgical debridement and antifungal, although the mortality rate was as high as 40%. We report two unique cases of renal and gastrointestinal mucormycosis as well. We concluded that poor glycemic control was the primary etiology behind the rise in the number of cases. Our report also stresses the importance of early surgical intervention and suggests further research comparing the efficacy of combination antifungal therapy versus single antifungal (amphotericin B) to help resource-limited settings in these times of drug crisis. How to cite this article: Yadav S, Sharma A, Kothari N, Bhatia PK, Goyal S, Goyal A. Mucormycosis: A Case Series of Patients Admitted in Non-COVID-19 Intensive Care Unit of a Tertiary Care Center during the Second Wave. Indian J Crit Care Med 2021;25(10):1193–1196.

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Renal Mucormycosis: A Rare Cause of Urinary Tract Infection Leading to End-stage Renal Disease (ESRD)

Cited by 6 publications

References 6 publications

Clinical presentations, diagnosis, management, and outcomes of renal mucormycosis: An overview of case reports

Clinical presentations, diagnosis, management, and outcomes of renal mucormycosis: An overview of case reports

Isolated renal mucormycosis in children: A case report and review of the literature

Mucormycosis: A Case Series of Patients Admitted in Non-COVID-19 Intensive Care Unit of a Tertiary Care Center during the Second Wave

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