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Bilateral renal mucormycosis following COVID-19 infection: A therapeutic challenge

India witnessed an epidemic of mucormycosis during the second wave of the COVID-19 pandemic. Renal mucormycosis has been reported rarely, mostly from India, but only 2 cases have been reported following COVID-19 infection to date. We report a case of mucormycosis predominantly affecting kidneys in a...

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Autores principales: Kumar, Rajasekaran Kishor, Annigeri, Rajeev A., Gopalakrishnan, Ram, Kaveripattu, Sunil S., Jain, Nitesh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dustri-Verlag Dr. Karl Feistle 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9707366/
https://www.ncbi.nlm.nih.gov/pubmed/36458102
http://dx.doi.org/10.5414/CNCS110874
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author Kumar, Rajasekaran Kishor
Annigeri, Rajeev A.
Gopalakrishnan, Ram
Kaveripattu, Sunil S.
Jain, Nitesh
author_facet Kumar, Rajasekaran Kishor
Annigeri, Rajeev A.
Gopalakrishnan, Ram
Kaveripattu, Sunil S.
Jain, Nitesh
author_sort Kumar, Rajasekaran Kishor
collection PubMed
description India witnessed an epidemic of mucormycosis during the second wave of the COVID-19 pandemic. Renal mucormycosis has been reported rarely, mostly from India, but only 2 cases have been reported following COVID-19 infection to date. We report a case of mucormycosis predominantly affecting kidneys in a young and previously healthy male following COVID-19 pneumonia, for which he had received corticosteroid, remdesivir, and tocilizumab. He presented with hematuria, progressive oliguria, and severe acute kidney injury (AKI) requiring dialysis. The diagnosis was made on kidney biopsy and contrast-enhanced CT (CECT) showed segmental and subsegmental renal artery pseudoaneurysms with distal occlusion of both kidneys. He underwent bilateral nephrectomy and received high-dose amphotericin (AMB) and posaconazole. He developed cardiac arrhythmia and pulmonary edema attributed to AMB-related cardiotoxicity after a cumulative ABM dose of 2,450 mg. This is the first case report describing the survival of a patient with bilateral renal mucormycosis following COVID-19 infection. Our case report highlights the importance of considering mucormycosis in a patient with post-COVID-19 AKI to make an early diagnosis and aggressive management comprising of surgical debridement and high-dose AMB to improve survival.
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spelling pubmed-97073662022-11-30 Bilateral renal mucormycosis following COVID-19 infection: A therapeutic challenge Kumar, Rajasekaran Kishor Annigeri, Rajeev A. Gopalakrishnan, Ram Kaveripattu, Sunil S. Jain, Nitesh Clin Nephrol Case Stud Case Report India witnessed an epidemic of mucormycosis during the second wave of the COVID-19 pandemic. Renal mucormycosis has been reported rarely, mostly from India, but only 2 cases have been reported following COVID-19 infection to date. We report a case of mucormycosis predominantly affecting kidneys in a young and previously healthy male following COVID-19 pneumonia, for which he had received corticosteroid, remdesivir, and tocilizumab. He presented with hematuria, progressive oliguria, and severe acute kidney injury (AKI) requiring dialysis. The diagnosis was made on kidney biopsy and contrast-enhanced CT (CECT) showed segmental and subsegmental renal artery pseudoaneurysms with distal occlusion of both kidneys. He underwent bilateral nephrectomy and received high-dose amphotericin (AMB) and posaconazole. He developed cardiac arrhythmia and pulmonary edema attributed to AMB-related cardiotoxicity after a cumulative ABM dose of 2,450 mg. This is the first case report describing the survival of a patient with bilateral renal mucormycosis following COVID-19 infection. Our case report highlights the importance of considering mucormycosis in a patient with post-COVID-19 AKI to make an early diagnosis and aggressive management comprising of surgical debridement and high-dose AMB to improve survival. Dustri-Verlag Dr. Karl Feistle 2022-11-24 /pmc/articles/PMC9707366/ /pubmed/36458102 http://dx.doi.org/10.5414/CNCS110874 Text en © Dustri-Verlag Dr. K. Feistle https://creativecommons.org/licenses/by/2.5/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kumar, Rajasekaran Kishor
Annigeri, Rajeev A.
Gopalakrishnan, Ram
Kaveripattu, Sunil S.
Jain, Nitesh
Bilateral renal mucormycosis following COVID-19 infection: A therapeutic challenge
title Bilateral renal mucormycosis following COVID-19 infection: A therapeutic challenge
title_full Bilateral renal mucormycosis following COVID-19 infection: A therapeutic challenge
title_fullStr Bilateral renal mucormycosis following COVID-19 infection: A therapeutic challenge
title_full_unstemmed Bilateral renal mucormycosis following COVID-19 infection: A therapeutic challenge
title_short Bilateral renal mucormycosis following COVID-19 infection: A therapeutic challenge
title_sort bilateral renal mucormycosis following covid-19 infection: a therapeutic challenge
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9707366/
https://www.ncbi.nlm.nih.gov/pubmed/36458102
http://dx.doi.org/10.5414/CNCS110874
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AT kaveripattusunils bilateralrenalmucormycosisfollowingcovid19infectionatherapeuticchallenge
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