title: Basidiobolomycosis complicated by hydronephrosis and a perinephric abscess presenting as a hypertensive emergency in a 7-year-old boy.
abstract: A 7-year-old boy presented with a chronic, indurated, tender left thigh swelling in association with a hypertensive emergency. He had a bilateral moderate degree of hydronephrosis and a left perinephric abscess, and MRI features of posterior reversible encephalopathy syndrome. Histopathological examination of the biopsy specimen demonstrated eosinophilic fasciitis with filamentous fungi. Basidiobolus ranarum was isolated from the culture. The fungus was also isolated from a perinephric fluid aspirate. Computerised tomography of the abdomen demonstrated features consistent with fungal invasion of the pelvic floor muscles and urinary bladder, leading to bilateral hydronephrosis. He required multiple antihypertensive drug therapy and was treated with intravenous amphotericin B, oral itraconazole and potassium iodide. Antihypertensive agents were discontinued after 2 weeks of antifungal therapy. At 6-months follow-up, the hydronephrosis had resolved completely. Perinephric abscess associated with basidiobolomycosis has not been reported previously.
authors.affiliation: a Department of Pediatrics , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry 605006 , India.
authors.forename: Sriram
authors.initials: S
authors.lastname: Krishnamurthy
authors.affiliation: b Department of Microbiology , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry , India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Singh
authors.affiliation: a Department of Pediatrics , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry 605006 , India.
authors.forename: Venkatesh
authors.initials: V
authors.lastname: Chandrasekaran
authors.affiliation: a Department of Pediatrics , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry 605006 , India.
authors.forename: Gopinathan
authors.initials: G
authors.lastname: Mathiyazhagan
authors.affiliation: b Department of Microbiology , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry , India.
authors.forename: Meenachi
authors.initials: M
authors.lastname: Chidambaram
authors.affiliation: c Department of Radiodiagnosis , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry , India.
authors.forename: S
authors.initials: S
authors.lastname: Deepak Barathi
authors.affiliation: a Department of Pediatrics , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry 605006 , India.
authors.forename: Subramanian
authors.initials: S
authors.lastname: Mahadevan
mesh_terms: D000038:Abscess / Q000175:diagnosis* / Q000473:pathology; D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001706:Biopsy; D002648:Child; D020091:Entomophthorales / Q000302:isolation & purification*; D006651:Histocytochemistry; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis* / Q000473:pathology; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D017964:Itraconazole / Q000008:administration & dosage; D008279:Magnetic Resonance Imaging; D008297:Male; D008853:Microscopy; D010501:Perinephritis / Q000175:diagnosis* / Q000473:pathology; D011193:Potassium Iodide / Q000008:administration & dosage; D011860:Radiography, Abdominal; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020096:Zygomycosis / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000935:Antifungal Agents; D000959:Antihypertensive Agents; D011193:Potassium Iodide; D017964:Itraconazole; D000666:Amphotericin B
keywords: Basidiobolomycosis; hydronephrosis; hypertension; perinephric abscess