Outcome of post-COVID-19 fungal pyelonephritis: A single Indian tertiary center experience.

Autor:	Pathak NJ; Department of Urology, MPUH, Nadiad, Gujarat, India., Surwase PP; Department of Urology, MPUH, Nadiad, Gujarat, India., Karthik US; Department of Urology, MPUH, Nadiad, Gujarat, India., Patil AP; Department of Urology, MPUH, Nadiad, Gujarat, India., Konnur AM; Department of Urology, MPUH, Nadiad, Gujarat, India., Soni SM; Department of Urology, MPUH, Nadiad, Gujarat, India., Singh AG; Department of Urology, MPUH, Nadiad, Gujarat, India., Ganpule AP; Department of Urology, MPUH, Nadiad, Gujarat, India., Sabnis RB; Department of Urology, MPUH, Nadiad, Gujarat, India., Desai MR; Department of Urology, MPUH, Nadiad, Gujarat, India.
Jazyk:	angličtina
Zdroj:	Indian journal of urology : IJU : journal of the Urological Society of India [Indian J Urol] 2022 Apr-Jun; Vol. 38 (2), pp. 121-127. Date of Electronic Publication: 2022 Apr 01.
DOI:	10.4103/iju.iju_31_22
Abstrakt:	Introduction: COVID-19 pandemic is associated with secondary opportunistic fungal infections. These have an aggressive course with a high mortality rate. We present our experience of seven cases of post-COVID-19 fungal pyelonephritis. Methods: An observational study over a period of 8 months of May to December 2021 was carried out at our tertiary care hospital, including all patients with features of fungal pyelonephritis in post-COVID-19 setting. The patient demographics, details of previous COVID-19 infection, details of present admission and management were collected. The endpoints were either discharge from the hospital or death. Results: Seven patients were included. Mean age of presentation was 42 years (range: 20-63 years, standard deviation ± 14.2). Male-to-female ratio was 6:1. One patient was diabetic. Two patients were asymptomatic, one had mild infection, and four patients had severe COVID-19 infection as per National Institute of Health criteria. In the present admission, all patients had symptomatic pyelonephritis with laboratory parameters showing elevated D dimer, C reactive protein, and total leukocyte counts. In all seven patients, ultrasound of kidney ureter bladder region showed bulky kidney, color Doppler showed main renal arterial thrombosis in two patients, segmental arterial thrombosis in another patient. Computed tomography scan was suggestive of changes of pyelonephritis in all patients with multiple renal hypodense areas. All patients required nephrectomy with biopsy suggestive of changes of necrotizing fungal inflammation. Three patients expired. Conclusion: Management of post-COVID-19 fungal pyelonephritis should be aggressive and suspicious laboratory and imaging findings should be treated by early nephrectomy. Competing Interests: Conflicts of interest: There are no conflicts of interest. (Copyright: © 2022 Indian Journal of Urology.)
Databáze:	MEDLINE
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