A noninvasive renal fungus ball caused by Rhizopus--a previously unreported manifestation of zygomycosis.
We describe the first reported case of renal zygomycosis presenting as an isolated fungus ball (bezoar) without renal parenchymal invasion. Since all previous descriptions of renal involvement have discussed tissue invasion, our case is unique in that the infection was confined solely in the renal pelvis and extended to the distal ureter without signs of contiguous renal infection. Our patient later developed renal insufficiency while receiving amphotericin B Lipid Complex (ABLC). The therapy was changed to posaconazole with subsequent clinical, mycologic, and radiographic improvement and the patient has remained free of recurrence 5 years after diagnosis.
Palacio-Bedoya
Federico
F
Departments of Internal Medicine, Division of Hospital Medicine, Fungus Testing Laboratory University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Cadena
Jose A
JA
Thompson
George R
GR
Sutton
Deanna A
DA
Owens
Aaron D
AD
Patterson
Thomas F
TF
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology*; D007682:Kidney Pelvis / Q000382:microbiology; D008297:Male; D009091:Mucormycosis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology*; D051437:Renal Insufficiency / Q000175:diagnosis; D012233:Rhizopus / Q000302:isolation & purification*; D014230:Triazoles / Q000627:therapeutic use; D014513:Ureter / Q000382:microbiology
D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole; D000666:Amphotericin B