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Case report
Community-acquired fungal pyelonephritis with renal infarction and gangrene of the colon: an uncommon diagnosis
  1. Stephen Varghese Samuel1,
  2. Tarun K George2,
  3. Vikram Raj Gopinathan3 and
  4. O C Abraham2
  1. 1Geriatric Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
  2. 2Internal Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
  3. 3Department of Pathology, Christian Medical College Vellore, Vellore, India
  1. Correspondence to Dr Tarun K George; tarunkg{at}gmail.com

Abstract

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 Candida 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.

  • infectious diseases
  • tropical medicine (infectious disease)
  • urinary tract infections

https://doi.org/10.1136/bcr-2021-241685

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    Footnotes

    • Twitter @stephenvsamuel

    • Contributors TG had full access to all data in the study and takes responsibility for the integrity of data and the accuracy of data analysis. Concept, design and planning and data analysis and interpretation and administrative, technical or material support: all authors. Data collection: SVS, TG and VRG. Reporting of the histopathological specimen: VRG. Manuscript writing: SVS and TG. Critical revision of the manuscript for important intellectual content: SVS, TG and OCA. Supervision: TG, VRG and OCA. Final approval of the published version: TG and OCA.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.