Details
Category: Volume 09 Issue 11 November 2021
Hits: 823

Title: A Rare Case of Renal Mucormycosis and its Management: A Case Report

Authors: Dr Muqqurab Ali Khan S, Dr Vamsi Krishna, Dr Keerthana Kota, Dr C.Nithish

 DOI: https://dx.doi.org/10.18535/jmscr/v9i11.24

Abstract

Introduction

Mucormycosis, which is also known as zygomycosis, refers to rare infections caused by fungi of the order of Mucorales, which are characterized by the production of aseptate hyphae and asexual spores[1]. Mucormycosis is more frequently seen in diabetic patients, followed by neutropenic patients, transplant recipients, patients with the haematological disease, patients on deferoxamine therapy, and IV drug users. The most common presentation of mucormycosis is rhinocerebral disease, followed by pulmonary, cutaneous, and disseminated diseases. Less commonly, mucormycosis can involve the kidneys[2,3]. Classically, invasive mucormycosis has been classified into six different clinical syndromes based on the general location of the disease: rhino-cerebral, pulmonary, gastrointestinal, cutaneous, disseminated and miscellaneous[4]. Renal involvement in disseminated mucormycosis occurs in up to 19% of patients[5]. As the Mucorales infections have an almost universal feature of extensive angioinvasion associated with thrombosis and ischemic necrosis, kidneys are similarly involved in the process with consequent complications[6]. The clinical manifestations of renal mucormycosis depend upon whether the disease is unilateral or bilateral and whether it is disseminated or isolated to the kidney[7]. 

References

  1. P. Kontoyiannis et.al., “Zygomycosis in the 1990s in a tertiary-care cancer  center,” Clinical Infectious Diseases, vol. 30, no. 6, pp. 851–856,2000.
  2. Brown, “Zygomycosis: an emerging fungal infection,” American Journal of Health-System Pharmacy, vol. 62, no. 24, pp. 2593–2596, 2005.
  3. CrumCianflone,“Mucormycosis,”Emedicine,http://emedicine.medscape.com/article/222551-overview.
  4. Roden MM, Zaoutis TE, et.al., Epidemiology and outcome of zygom-ycosis: a review of 929 reported cases. Clin Infect Dis. 2005 1;41(5):634-53. 
  5. Chakrabarti A, Das A, Sharma A, Panda N, Das S, Gupta KL, et al. Ten yearsí experience in zygomycosis at a tertiary care centre in India. J Infect 2001;42:261-6.
  6. Zygomycetes in human disease Ribes JA, Vanover-Sams CL, Baker DJ Clin Microbiol Rev. 2000 Apr; 13(2):236-301.
  7. Epidemiology and outcome of zygomycosis: a review of 929 reported cases.
  8. Spellberg B, Edwards J Jr, and Ibrahim A. 2005. Novel perspectives on mucormycosis: pathophysiology, presentation, and management.  Microbiol. Rev.18:556–569.
  9. Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RL, Sein M, Sein T, Chiou CC, Chu JH, Kontoyiannis DP, and Walsh TJ. 2005
  10. Epidemiology and outcome of zygomycosis: a review of 929 reported cases.  Infect. Dis.41:634–653.
  11. Spellberg B, Edwards J Jr, and Ibrahim A. 2005. Novel perspectives on mucormycosis: pathophysiology, presentation, and management.  Microbiol. Rev.18:556–569, 5.  
  12. Hammond SP, Baden LR, and Marty FM. 2011. Mortality in hematologic malignancy and hematopoietic stem cell transplant patients with mucormycosis, 2001 to 2009.  Agents Chemother.55:5018–5021
  13. Deepak L Bhatt et.al., Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomised trial., The Lancet: Published online September 1, 2019.
  14. Bianca Graves et.al., Isavuconazole as salvage therapy for mucormycosis  Medical Mycology Case Reports Volume 11, March 2016, Pages 36-39.
  15. Dimitrova, G., Tulman, D. B., & Bergese, S. D. (2012). Perioperative management of antiplatelet therapy in patients with drug-eluting stents. HSR proceedings in intensive care & cardiovascular anesthesia, 4(3), 153–167.
  16. Chakrabarti A, Das A, Sharma A, Panda N, Das S, Gupta KL, et al. Ten years’ experience in zygomycosis at a tertiary care centre in India. J Infect. 2001;42:261–6.
  17. Verma R, Vij M, Agrawal V, Jain M. Renal mucormycosis in immunocompetent patients: Report of three cases. Basic Appl Pathol. 2011;4:66–70.

Corresponding Author

Dr Muqqurab Ali Khan S

Department of Urology, Care Hospitals, Banjara Hills, Hyderabad, India