title: Isolated renal zygomycosis: novel diagnostic and prognostic criteria with experience of a tertiary care center.
abstract: BACKGROUND
  Isolated renal zygomycosis is a life-threatening infection and difficult to diagnose ante mortem due to varied presentations. Most reports in the literature are case reports. We are presenting our experience of 10 patients.
  
  
  METHODS
  Retrospective data of 10 consecutive patients with primary renal zygomycosis, including 2 post-transplant patients, in our tertiary care center was analyzed. Epidemiological characteristics, predisposing conditions, clinical presentation, diagnostic findings and treatment outcomes were recorded. Characteristic radiological findings were recorded. Localized disease was managed by supportive treatment or percutaneous drainage and extensive disease with unilateral or bilateral nephrectomy. Renal involvement was confirmed in all patients by histopathology.
  
  
  RESULTS
  The mean age of presentation was 35 years. Five patients who had bilateral renal involvement presented with oliguric acute renal failure, hematuria and abdominal pain. Three had unilateral renal disease and presented with flank pain and fever. The two post-transplant patients presented with fever and graft dysfunction. Even after aggressive treatment 5 patients died, accounting for a mortality rate of 50%.
  
  
  CONCLUSIONS
  Isolated renal zygomycosis can be diagnosed with typical radiological findings, combined with clinical, laboratory and histopathological features. This study describes the newer ante mortem radiological diagnostic criteria and prognostic predictors of the disease.
authors.affiliation: Departments of Urology and Kidney Transplant, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Saurabh S
authors.initials: SS
authors.lastname: Chipde
authors.forename: Priyadarshi
authors.initials: P
authors.lastname: Ranjan
authors.forename: Hira
authors.initials: H
authors.lastname: Lal
authors.forename: Vivek
authors.initials: V
authors.lastname: Singh
authors.forename: Ram
authors.initials: R
authors.lastname: Naval
authors.forename: Rungmei S
authors.initials: RS
authors.lastname: Marak
authors.forename: Anand
authors.initials: A
authors.lastname: Prakash
authors.forename: Dharmendra
authors.initials: D
authors.lastname: Bhadoria
authors.forename: R K
authors.initials: RK
authors.lastname: Sharma
authors.forename: Rohit
authors.initials: R
authors.lastname: Kapoor
authors.forename: Manas Ranjan
authors.initials: MR
authors.lastname: Pradhan
authors.forename: Manmeet
authors.initials: M
authors.lastname: Singh
authors.forename: Jatinder
authors.initials: J
authors.lastname: Kumar
authors.forename: Mohammad S
authors.initials: MS
authors.lastname: Ansari
authors.forename: Anil
authors.initials: A
authors.lastname: Mandhani
authors.forename: Aneesh
authors.initials: A
authors.lastname: Srivastava
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kapoor
mesh_terms: D015746:Abdominal Pain / Q000382:microbiology; D058186:Acute Kidney Injury / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D001706:Biopsy; D003952:Diagnostic Imaging / Q000379:methods; D005334:Fever / Q000382:microbiology; D021501:Flank Pain / Q000382:microbiology; D006417:Hematuria / Q000382:microbiology; D006801:Humans; D007194:India; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009846:Oliguria / Q000382:microbiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D055815:Young Adult; D020096:Zygomycosis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy