Candida tropicalis in the tropics: A rare fungal cause of perinephric abscess.

Abstract

Perinephric and renal abscess are very rare entities with insidious presentation and pose a great diagnostic challenge, common etiology being bacterial. Only less than 30 cases of fungal etiology have been reported in literature. Herein, we report first case of fungal perinephric abscess caused by Candida tropicalis in a young diabetic female who presented with right flank pain and vomiting. Diagnosis made by CT imaging and culture of USG guided aspiration of perinephric abscess revealed growth of Candida tropicalis. Candida tropicalis perinephric abscess requires a very high index of suspicion for diagnosis. Associated high morbidity and mortality rates are likely due to misdiagnosis, therefore fungal perinephric and renal abscess must be kept as differential diagnosis in cases of fever with abdominal pain. Prompt diagnosis and early treatment are important for better outcome. Imaging and microbiological investigations are required for diagnosis, and drainage is indicated for successful therapy.