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Case Reports
. 2024 Apr 1;3(2):94453.
doi: 10.56305/001c.94453. eCollection 2024.

Candida-Associated Renal Papillary Necrosis Following Severe COVID-19 Infection

Ranjani Ravi  1 , Aravind Reghukumar  2 , Vimala A  1 , Sreeja S Nair  1 , Jinsi N  1 , Indu S  3
Affiliations
Case Reports

Candida-Associated Renal Papillary Necrosis Following Severe COVID-19 Infection

Ranjani Ravi et al. J Brown Hosp Med. .

Abstract

Candida-associated renal papillary necrosis is rare. The few cases described previously were secondary to candidemia, especially in immunocompromised hosts. We describe two patients who presented with hydroureteronephrosis and were diagnosed with candida-associated renal papillary necrosis. Both patients had a history of severe COVID-19 infection within the past year and had been treated with immunosuppressants. Both patients underwent double J stenting and anti-fungal treatment with fluconazole. One patient recovered completely, while the other patient who had chronic kidney disease stage 4 at diagnosis progressed to dialysis-dependent renal failure later following an episode of bacterial sepsis. The incidence of candida-associated renal papillary necrosis may reflect the immunomodulatory effects of COVID-19, immunosuppressants, or a combination of both.

Keywords: candida; candidial papillary necrosis; candiduria; covid-19; post covid fungal infections; renal papillary necrosis.

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Conflict of interest statement

The Authors declare no conflict of interest

Figures

Figure 1.
Figure 1.. Timeline of development of infection in both patients
DM – Diabetes Mellitus HTN – Hypertension CAD – Coronary Artery disease HUN – Hydroureteronephrosis HD - Hemodialysis
Figure 2.
Figure 2.. Flaky tissue in urine specimen
Figure 3.
Figure 3.. Tissue obtained from urine showing Papillary necrosis with Candida
Figure 4.
Figure 4.. Growth of Candida parapsilosis in sabouraud dextrose agar, Colonies are cream colored, smooth and yeast like in appearance. It has grown rapidly within 24 hours both at 37”C and at room temperature
Figure 5.
Figure 5.. Candida parapsilosis gram staining shows gram positive budding yeast cells 2-4micrometer in size, large ovoid or spherical in shape visible under oil immersion microscope
See this image and copyright information in PMC

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