Mucor pyelonephritis. Report of a case diagnosed by urine cytology, with diagnostic considerations in the workup of funguria.

BACKGROUND: Isolated renal mucormycosis is an uncommon kidney infection affecting patients with underlying systemic diseases and intravenous (IV) drug abuse. We report a unique case in the cytologic literature in which urine cytology provided insight into the diagnosis, renal mucormycosis. CASE: The patient, a diabetic and IV drug abuser, presented with complaints of left flank pain, fever and dysuria. All urine cultures were negative. A computed tomography (CT) scan showed changes consistent with left acute pyelonephritis, and the patient was treated for a presumed diagnosis of bacterial pyelonephritis. Late in the hospital stay, the cytology laboratory diagnosed Mucor in a single urine specimen, but the patient had already been discharged. The patient was never treated for funguria, only to present again with left flank pain 13 months later. An abdominopelvic CT scan showed progression to left chronic pyelonephritis. The patient, however, left the hospital against medical advice before any further workup could be completed. CONCLUSION: Renal mucormycosis should be considered part of the differential diagnosis in patients with underlying diseases or IV drug abuse who present with symptoms of acute pyelonephritis. The differential diagnosis of Mucor funguria should also include fungal ball in the renal pelvis or urinary bladder and fungal cystitis.

Experimental systemic bovine zygomycosis with reference to pathology and secretion of antigen into urine.

ELISA and immunoblotting were applied for the characterization of somatic antigens from Absidia corymbifera. Immunoblotting revealed major antigenic bands at 11 to 81 kDa. The ELISA showed some crossreactivity towards somatic antigens from other fungi. However, the crossreactivity was especially observed with somatic antigens from other fungi of the zygomycetes. The ELISA and immunoblotting assays were applied to urine samples from two groups of 3 calves each systemically infected with A. corymbifera and Aspergillus fumigatus, respectively. The immunoreactivity of the urine samples was similar by the two assays. Somatic antigens were demonstrated in the urine of all three calves infected with A.corymbifera, whereas only one of the calves with systemic aspergillosis was antigen positive. The level of antigen in the positive urine samples varied from 50 to 210 ng/ml.