Cargando…

Renal mucormycosis presenting during the COVID-19 pandemic: A series of 11 cases from a tertiary care center in India

INTRODUCTION: Renal mucormycosis has been documented to occur even in apparently immunocompetent individuals. Owing to the rarity of this disease, literature on its management is small. We present our experience of diagnosing and managing 11 cases of primary renal mucormycosis who presented during t...

Descripción completa

Detalles Bibliográficos
Autores principales: Madduri, Vijay Kumar Sarma, Jena, Rahul, Baid, Gaurav, Choudhary, Gautam Ram, Sandhu, Arjun Singh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8992718/
https://www.ncbi.nlm.nih.gov/pubmed/35400861
http://dx.doi.org/10.4103/iju.iju_437_21
_version_ 1784683785746382848
author Madduri, Vijay Kumar Sarma
Jena, Rahul
Baid, Gaurav
Choudhary, Gautam Ram
Sandhu, Arjun Singh
author_facet Madduri, Vijay Kumar Sarma
Jena, Rahul
Baid, Gaurav
Choudhary, Gautam Ram
Sandhu, Arjun Singh
author_sort Madduri, Vijay Kumar Sarma
collection PubMed
description INTRODUCTION: Renal mucormycosis has been documented to occur even in apparently immunocompetent individuals. Owing to the rarity of this disease, literature on its management is small. We present our experience of diagnosing and managing 11 cases of primary renal mucormycosis who presented during the second wave of the COVID-19 pandemic in India. METHODS: We reviewed the records of all patients presenting to our institute with a diagnosis of acute pyelonephritis from March 2021 to September 2021. All patients with a radiological, microbiological, or histopathological diagnosis of renal mucormycosis were included in the analysis and all demographic and clinical details, including a history of COVID-19 disease and its treatment, were noted. All patients were treated by a combination of intravenous antifungal therapy and aggressive surgical debridement including nephrectomy and multivisceral resection as required. Predictors of mortality were evaluated by statistical analysis. RESULTS: A total of 93 patients presented to our hospital with features of acute pyelonephritis of which 11 patients were suspected to have primary renal mucormycosis based on characteristic imaging features and confirmed on microbiological and histopathological examination. Of these, four patients had a history of COVID-19 infection. Only one patient had diabetes mellitus. Ten patients underwent nephrectomy and seven needed resections of surrounding organs. The colon was the most commonly involved organ. Five patients (45.5%) died of progressive sepsis. None of the predictors of mortality that were analyzed showed statistical significance. CONCLUSION: A high index of suspicion, early cross-sectional imaging, prompt institution of antifungal therapy, and aggressive surgical extirpation are very important for achieving good outcomes in patients of primary renal mucormycosis.
format Online
Article
Text
id pubmed-8992718
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Wolters Kluwer - Medknow
record_format MEDLINE/PubMed
spelling pubmed-89927182022-04-09 Renal mucormycosis presenting during the COVID-19 pandemic: A series of 11 cases from a tertiary care center in India Madduri, Vijay Kumar Sarma Jena, Rahul Baid, Gaurav Choudhary, Gautam Ram Sandhu, Arjun Singh Indian J Urol Original Article INTRODUCTION: Renal mucormycosis has been documented to occur even in apparently immunocompetent individuals. Owing to the rarity of this disease, literature on its management is small. We present our experience of diagnosing and managing 11 cases of primary renal mucormycosis who presented during the second wave of the COVID-19 pandemic in India. METHODS: We reviewed the records of all patients presenting to our institute with a diagnosis of acute pyelonephritis from March 2021 to September 2021. All patients with a radiological, microbiological, or histopathological diagnosis of renal mucormycosis were included in the analysis and all demographic and clinical details, including a history of COVID-19 disease and its treatment, were noted. All patients were treated by a combination of intravenous antifungal therapy and aggressive surgical debridement including nephrectomy and multivisceral resection as required. Predictors of mortality were evaluated by statistical analysis. RESULTS: A total of 93 patients presented to our hospital with features of acute pyelonephritis of which 11 patients were suspected to have primary renal mucormycosis based on characteristic imaging features and confirmed on microbiological and histopathological examination. Of these, four patients had a history of COVID-19 infection. Only one patient had diabetes mellitus. Ten patients underwent nephrectomy and seven needed resections of surrounding organs. The colon was the most commonly involved organ. Five patients (45.5%) died of progressive sepsis. None of the predictors of mortality that were analyzed showed statistical significance. CONCLUSION: A high index of suspicion, early cross-sectional imaging, prompt institution of antifungal therapy, and aggressive surgical extirpation are very important for achieving good outcomes in patients of primary renal mucormycosis. Wolters Kluwer - Medknow 2022 2022-04-01 /pmc/articles/PMC8992718/ /pubmed/35400861 http://dx.doi.org/10.4103/iju.iju_437_21 Text en Copyright: © 2022 Indian Journal of Urology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Madduri, Vijay Kumar Sarma
Jena, Rahul
Baid, Gaurav
Choudhary, Gautam Ram
Sandhu, Arjun Singh
Renal mucormycosis presenting during the COVID-19 pandemic: A series of 11 cases from a tertiary care center in India
title Renal mucormycosis presenting during the COVID-19 pandemic: A series of 11 cases from a tertiary care center in India
title_full Renal mucormycosis presenting during the COVID-19 pandemic: A series of 11 cases from a tertiary care center in India
title_fullStr Renal mucormycosis presenting during the COVID-19 pandemic: A series of 11 cases from a tertiary care center in India
title_full_unstemmed Renal mucormycosis presenting during the COVID-19 pandemic: A series of 11 cases from a tertiary care center in India
title_short Renal mucormycosis presenting during the COVID-19 pandemic: A series of 11 cases from a tertiary care center in India
title_sort renal mucormycosis presenting during the covid-19 pandemic: a series of 11 cases from a tertiary care center in india
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8992718/
https://www.ncbi.nlm.nih.gov/pubmed/35400861
http://dx.doi.org/10.4103/iju.iju_437_21
work_keys_str_mv AT maddurivijaykumarsarma renalmucormycosispresentingduringthecovid19pandemicaseriesof11casesfromatertiarycarecenterinindia
AT jenarahul renalmucormycosispresentingduringthecovid19pandemicaseriesof11casesfromatertiarycarecenterinindia
AT baidgaurav renalmucormycosispresentingduringthecovid19pandemicaseriesof11casesfromatertiarycarecenterinindia
AT choudharygautamram renalmucormycosispresentingduringthecovid19pandemicaseriesof11casesfromatertiarycarecenterinindia
AT sandhuarjunsingh renalmucormycosispresentingduringthecovid19pandemicaseriesof11casesfromatertiarycarecenterinindia