Urinary tract mycosis masquerading as renal papillary necrosis post-COVID: A case report

Anjali Sathya, Radha Venkatramanan, C. R. Kumar, Sarah Grace Priyadarshini, Consultant Endocrinologist, Consultant Nephrologist, Consultant Urologist
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Abstract

Urinary tract mycosis is more often seen in hospitalized patients than in community-acquired ones. Funguria is common but becomes invasive and life-threatening in immunosuppressed patients such as with diabetes mellitus, post-transplant, chronic antibiotic usage, cancer chemotherapy, and long-term steroids. In the last 2 years, the world has witnessed one of its worst pandemics with the COVID-19 infection, killing millions of people. Deaths have been due to the virus or secondary complications thereafter. Secondary fungal infections, especially those caused by mucormycosis, have been on the rise, the majority of which have been reported from India. The rhino-cerebral-pulmonary form is the most common, followed by isolated case reports of gastrointestinal, cutaneous, and musculoskeletal mucormycosis. Isolated renal and urinary tract mycosis in COVID-19 is an extremely rare association. We report a case of a middle-aged man with fairly well-controlled diabetes who received steroids for COVID-19 infection and, about 8 weeks later, presented with non-invasive mixed mycosis of the urinary tract that was managed conservatively without any surgical intervention.
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COVID后伪装成肾乳头坏死的尿路霉菌病:病例报告
尿路真菌病多见于住院病人,而非社区获得性病人。真菌病很常见,但在糖尿病、器官移植后、长期使用抗生素、癌症化疗和长期使用类固醇等免疫抑制患者中,真菌病会成为侵袭性疾病并危及生命。在过去的两年中,COVID-19 感染已成为世界上最严重的流行病之一,造成数百万人死亡。死亡的原因是病毒或其后的继发性并发症。继发性真菌感染,尤其是由粘孢子菌病引起的继发性真菌感染呈上升趋势,其中大部分报告来自印度。最常见的是鼻-脑-肺粘孢子菌病,其次是胃肠道、皮肤和肌肉骨骼粘孢子菌病的个别病例报告。COVID-19 中孤立的肾脏和泌尿道粘液瘤病是一种极为罕见的疾病。我们报告了一例糖尿病控制良好的中年男子的病例,他因感染 COVID-19 而接受类固醇治疗,约 8 周后出现非侵袭性泌尿道混合霉菌病,经保守治疗后未进行任何手术干预。
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