Pahwa Mrinal, Pahwa Archna R, Girotra Mohit, Chawla Arun
Department of Urology, Sir Ganga Ram Hospital, New Delhi, India.
Korean J Urol. 2013 Sep;54(9):641-3. doi: 10.4111/kju.2013.54.9.641. Epub 2013 Sep 10.
Isolated renal mucormycosis is rarely identified and has been described in only a handful of cases. We hereby report a case of isolated renal mucormycosis with an atypical presentation in an immunocompetent patient with no identifiable risk factors. A 30-year-old nondiabetic male presented with a poorly functioning right kidney with minimal constitutional symptoms. The patient underwent a right simple nephrectomy. Histopathology revealed necrotizing xanthogranulomatous pyelonephritis with mucormycosis. The postoperative period was uneventful and the patient was managed without any antifungal administration. We hereby emphasize that renal mucormycosis can affect immunocompetent healthy adults without any previously known risk factors and that asymptomatic patients with no evidence of fungemia or disseminated disease can be managed without administration of intravenous amphotericin.
孤立性肾毛霉病很少被确诊,仅有少数病例报道。我们在此报告一例免疫功能正常且无明确危险因素的患者出现非典型表现的孤立性肾毛霉病。一名30岁非糖尿病男性因右肾功能不佳且全身症状轻微就诊。患者接受了右肾单纯切除术。组织病理学显示为坏死性黄色肉芽肿性肾盂肾炎合并毛霉病。术后恢复顺利,患者未接受任何抗真菌治疗。我们在此强调,肾毛霉病可在无任何已知危险因素的免疫功能正常的健康成年人中发生,对于无真菌血症或播散性疾病证据的无症状患者,可不给予静脉注射两性霉素进行治疗。