Community-acquired fungal pyelonephritis with renal infarction and gangrene of the colon: an uncommon diagnosis
A 54-year-old male farmer with a history of long-standing uncontrolled type 2 diabetes mellitus (HbA1c 10.8) presented with a 3-week history of fever, intermittent vomiting, malaise and left flank pain for which he was treated with broad-spectrum antibiotics and oral antifungals for isolated from ur...
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| Veröffentlicht in: | BMJ case reports 2022-02, Vol.15 (2), p.e241685 |
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| creator | Samuel, Stephen Varghese George, Tarun K Gopinathan, Vikram Raj Abraham, O C |
| description | A 54-year-old male farmer with a history of long-standing uncontrolled type 2 diabetes mellitus (HbA1c 10.8) presented with a 3-week history of fever, intermittent vomiting, malaise and left flank pain for which he was treated with broad-spectrum antibiotics and oral antifungals for
isolated from urine culture. CT of the abdomen revealed predominant involvement of the left kidney and retroperitoneal structures. Nephrectomy was performed due to worsening abdominal pain and features of bowel perforation found on imaging. Pus culture from the necrotic kidney grew aseptate fungal hyphae, and the histopathological examination was suggestive of zygomycosis. He received amphotericin B postoperatively, but his condition deteriorated and he succumbed to nosocomial gram-negative septicaemia. |
| doi_str_mv | 10.1136/bcr-2021-241685 |
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isolated from urine culture. CT of the abdomen revealed predominant involvement of the left kidney and retroperitoneal structures. Nephrectomy was performed due to worsening abdominal pain and features of bowel perforation found on imaging. Pus culture from the necrotic kidney grew aseptate fungal hyphae, and the histopathological examination was suggestive of zygomycosis. He received amphotericin B postoperatively, but his condition deteriorated and he succumbed to nosocomial gram-negative septicaemia.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2021-241685</identifier><identifier>PMID: 35131766</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Abdomen ; Acids ; Antibiotics ; Antifungal agents ; Blood ; Cardiovascular disease ; Case Report ; Case reports ; Colon ; Creatinine ; Debridement ; Diabetes ; Diabetes Mellitus, Type 2 - complications ; Edema ; Fever ; Gangrene ; Humans ; Infarction - diagnostic imaging ; Kidneys ; Laparotomy ; Male ; Medical diagnosis ; Middle Aged ; Pain ; Penis ; Proteins ; Pyelonephritis - complications ; Pyelonephritis - diagnosis ; Pyelonephritis - drug therapy ; Sepsis ; Ultrasonic imaging ; Urinary tract infections ; Urine</subject><ispartof>BMJ case reports, 2022-02, Vol.15 (2), p.e241685</ispartof><rights>BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2022 BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ. 2022</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c380t-c88e8fa34fc068becf4e83685bd55d154c96f4a56bd78b1b00133329c8ccb9a13</citedby><cites>FETCH-LOGICAL-c380t-c88e8fa34fc068becf4e83685bd55d154c96f4a56bd78b1b00133329c8ccb9a13</cites><orcidid>0000-0002-3123-2029 ; 0000-0002-1377-8685</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8823032/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8823032/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35131766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Samuel, Stephen Varghese</creatorcontrib><creatorcontrib>George, Tarun K</creatorcontrib><creatorcontrib>Gopinathan, Vikram Raj</creatorcontrib><creatorcontrib>Abraham, O C</creatorcontrib><title>Community-acquired fungal pyelonephritis with renal infarction and gangrene of the colon: an uncommon diagnosis</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>A 54-year-old male farmer with a history of long-standing uncontrolled type 2 diabetes mellitus (HbA1c 10.8) presented with a 3-week history of fever, intermittent vomiting, malaise and left flank pain for which he was treated with broad-spectrum antibiotics and oral antifungals for
isolated from urine culture. CT of the abdomen revealed predominant involvement of the left kidney and retroperitoneal structures. Nephrectomy was performed due to worsening abdominal pain and features of bowel perforation found on imaging. Pus culture from the necrotic kidney grew aseptate fungal hyphae, and the histopathological examination was suggestive of zygomycosis. He received amphotericin B postoperatively, but his condition deteriorated and he succumbed to nosocomial gram-negative septicaemia.</description><subject>Abdomen</subject><subject>Acids</subject><subject>Antibiotics</subject><subject>Antifungal agents</subject><subject>Blood</subject><subject>Cardiovascular disease</subject><subject>Case Report</subject><subject>Case reports</subject><subject>Colon</subject><subject>Creatinine</subject><subject>Debridement</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Edema</subject><subject>Fever</subject><subject>Gangrene</subject><subject>Humans</subject><subject>Infarction - diagnostic imaging</subject><subject>Kidneys</subject><subject>Laparotomy</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Middle Aged</subject><subject>Pain</subject><subject>Penis</subject><subject>Proteins</subject><subject>Pyelonephritis - complications</subject><subject>Pyelonephritis - diagnosis</subject><subject>Pyelonephritis - drug therapy</subject><subject>Sepsis</subject><subject>Ultrasonic imaging</subject><subject>Urinary tract infections</subject><subject>Urine</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkc1LxDAQxYMo7qKevUnAi5e6SdOkqQdBFr9A8KLgLaRp0s3SJrtJq-x_b3RV1Fwm8H7zmJkHwDFG5xgTNqtVyHKU4ywvMON0B0xxScusrNDL7q__BBzFuETpEVzwguyDCaGY4JKxKfBz3_ejs8Mmk2o92qAbaEbXyg6uNrrzTq8WwQ42wjc7LGDQLinWGRnUYL2D0jWwla5NgobewGGhofKp7yJJcHQq2SessbJ1Ptp4CPaM7KI--qoH4Pnm-ml-lz083t7Prx4yRTgaMsW55kaSwijEeK2VKTQnacm6obTBtFAVM4WkrG5KXuMaIUwIySvFlaorickBuNz6rsa6143SbgiyE6tgexk2wksr_irOLkTrXwXnOUEkTwZnXwbBr0cdB9HbqHTXSaf9GEXOcsZ5VdIqoaf_0KUfQzrUlsIFpZ_UbEup4GMM2vwMg5H4yFOkPMVHnmKbZ-o4-b3DD_-dHnkHd-Ceuw</recordid><startdate>20220207</startdate><enddate>20220207</enddate><creator>Samuel, Stephen Varghese</creator><creator>George, Tarun K</creator><creator>Gopinathan, Vikram Raj</creator><creator>Abraham, O C</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3123-2029</orcidid><orcidid>https://orcid.org/0000-0002-1377-8685</orcidid></search><sort><creationdate>20220207</creationdate><title>Community-acquired fungal pyelonephritis with renal infarction and gangrene of the colon: an uncommon diagnosis</title><author>Samuel, Stephen Varghese ; 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| subjects | Abdomen Acids Antibiotics Antifungal agents Blood Cardiovascular disease Case Report Case reports Colon Creatinine Debridement Diabetes Diabetes Mellitus, Type 2 - complications Edema Fever Gangrene Humans Infarction - diagnostic imaging Kidneys Laparotomy Male Medical diagnosis Middle Aged Pain Penis Proteins Pyelonephritis - complications Pyelonephritis - diagnosis Pyelonephritis - drug therapy Sepsis Ultrasonic imaging Urinary tract infections Urine |
| title | Community-acquired fungal pyelonephritis with renal infarction and gangrene of the colon: an uncommon diagnosis |
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