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Chronic renal failure presenting for the first time as pulmonary mucormycosis with a fatal outcome.

Jayakrishnan B, Al Aghbari J, Rizavi D, Srinivasan S, Lakhtakia R, Al Riyami D - Case Rep Nephrol (2015)

Bottom Line: Renal failure as the predominant presenting feature is not common in mucormycosis.Moreover, sudden, massive hemoptysis is not a usual complication.In this report we describe fatal pulmonary mucormycosis in a young patient with a previously undiagnosed chronic renal failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Sultan Qaboos University Hospital, 123 Muscat, Oman.

ABSTRACT
Pulmonary mucormycosis is an uncommon, but important, opportunistic fungal pneumonia which is often diagnosed late. Renal failure as the predominant presenting feature is not common in mucormycosis. Moreover, sudden, massive hemoptysis is not a usual complication. In this report we describe fatal pulmonary mucormycosis in a young patient with a previously undiagnosed chronic renal failure.

No MeSH data available.


Related in: MedlinePlus

Bronchoalveolar lavage specimen showing broad, irregular, aseptate hyphae of Mucor with wide angled branching (arrow-heads) in a neutrophil-rich inflammatory background. (a) Papanicolaou (smear) ×600 and (b) haematoxylin and eosin (cell block) ×600.
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fig3: Bronchoalveolar lavage specimen showing broad, irregular, aseptate hyphae of Mucor with wide angled branching (arrow-heads) in a neutrophil-rich inflammatory background. (a) Papanicolaou (smear) ×600 and (b) haematoxylin and eosin (cell block) ×600.

Mentions: The grossly elevated creatinine and urea, low hemoglobin, severe metabolic acidosis, bilateral small kidneys in ultrasound scan of the abdomen, and a high white cell count suggested a primary renal involvement complicated by a pneumonic illness and possibly sepsis. He deteriorated rapidly and was electively intubated and mechanical ventilation was initiated. He received supportive care, fluids, measures to reduce potassium, and broad spectrum antibiotics. Since the acidosis and the renal function did not show any improvement, he was taken up for dialysis later on the same day. Bronchoscopy showed inflamed right bronchi and the subdivisions lined by a thick layer of yellow secretions (Figure 2). The bronchial washings and brushings showed broad aseptate hyphae with right angled branching consistent with Mucor species (Figure 3).


Chronic renal failure presenting for the first time as pulmonary mucormycosis with a fatal outcome.

Jayakrishnan B, Al Aghbari J, Rizavi D, Srinivasan S, Lakhtakia R, Al Riyami D - Case Rep Nephrol (2015)

Bronchoalveolar lavage specimen showing broad, irregular, aseptate hyphae of Mucor with wide angled branching (arrow-heads) in a neutrophil-rich inflammatory background. (a) Papanicolaou (smear) ×600 and (b) haematoxylin and eosin (cell block) ×600.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4309303&req=5

fig3: Bronchoalveolar lavage specimen showing broad, irregular, aseptate hyphae of Mucor with wide angled branching (arrow-heads) in a neutrophil-rich inflammatory background. (a) Papanicolaou (smear) ×600 and (b) haematoxylin and eosin (cell block) ×600.
Mentions: The grossly elevated creatinine and urea, low hemoglobin, severe metabolic acidosis, bilateral small kidneys in ultrasound scan of the abdomen, and a high white cell count suggested a primary renal involvement complicated by a pneumonic illness and possibly sepsis. He deteriorated rapidly and was electively intubated and mechanical ventilation was initiated. He received supportive care, fluids, measures to reduce potassium, and broad spectrum antibiotics. Since the acidosis and the renal function did not show any improvement, he was taken up for dialysis later on the same day. Bronchoscopy showed inflamed right bronchi and the subdivisions lined by a thick layer of yellow secretions (Figure 2). The bronchial washings and brushings showed broad aseptate hyphae with right angled branching consistent with Mucor species (Figure 3).

Bottom Line: Renal failure as the predominant presenting feature is not common in mucormycosis.Moreover, sudden, massive hemoptysis is not a usual complication.In this report we describe fatal pulmonary mucormycosis in a young patient with a previously undiagnosed chronic renal failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Sultan Qaboos University Hospital, 123 Muscat, Oman.

ABSTRACT
Pulmonary mucormycosis is an uncommon, but important, opportunistic fungal pneumonia which is often diagnosed late. Renal failure as the predominant presenting feature is not common in mucormycosis. Moreover, sudden, massive hemoptysis is not a usual complication. In this report we describe fatal pulmonary mucormycosis in a young patient with a previously undiagnosed chronic renal failure.

No MeSH data available.


Related in: MedlinePlus