Isolated Renal Mucormycosis by Apophysomyces in an Immunocompetent Adult

Abstract

ABSTRACT Isolated renal mucormycosis (IRM) in an apparently healthy immunocompetent adult is a rare entity with most cases reported from India and China. Fever not responding to antibiotics, sterile pyuria, and characteristic imaging findings are strong pointers toward renal mucormycosis. We report a rare case of IRM due to Apophysomyces elegans in an apparently healthy young adult who underwent bilateral nephrectomy and ultimately succumbed to sepsis. Clinical indicators such as fever not responding to antibiotics, severe flank tenderness, sterile pyuria, and characteristic computed tomography findings (diffuse or patchy areas of absent contrast enhancement, perinephric fat stranding, and thickened Gerota’s fascia) are strong pointers toward renal mucormycosis. Aggressive surgical debridement and timely antifungal is imperative for favorable patient outcome in this aggressive infection.