Case Reports
Pyomyositis with Hepatic and Perinephric Abscesses Caused by Candida albicans in a Diabetic Nephropathy Patient

https://doi.org/10.1097/00000441-200605000-00013Get rights and content

ABSTRACT

Both disseminated candidiasis and pyomyositis are rare and mainly encountered in severely immunocompromised hosts. To our knowledge, Candida albicans related pyomyositis with formation of multiple visceral abscesses in a diabetic nephropathy patient has never previously been reported. A 47-year-old man with diabetic nephropathy and alcoholic liver disease developed disseminated candidiasis, with the initial presentation of pyomyositis. Debridement was performed and intravenous fluconazole commenced. Despite development of a single hepatic and multiple perinephric abscesses, the patient made a full recovery after completion of a 12-week course of intravenous fluconazole therapy. Candida species should be considered a potential pathogen in patients with predisposing factors.

Section snippets

Case Report

A 47-year-old man with alcoholic liver disease, poorly controlled type 2 diabetes, and diabetic nephropathy was admitted due to Klebsiella pneumoniae–associated urinary tract infection. Medical history included sepsis 3 months prior to the most recent admission, involving admission to the intensive care unit after the development of nosocomial pneumonia with respiratory failure. The patient was intubated, treated with ceftriaxone and piperacillin/tazobactum, and received total parenteral

Discussion

Features associated with the development of disseminated candidiasis include antecedent broad-spectrum and prolonged antibiotic therapy, combination treatments containing aminoglycoside, long hospitalization, parenteral nutrition, corticosteroid therapy, cancer chemotherapy, renal transplantation, and neutropenia.2., 3. Hepatosplenic candidiasis has been described as a feature of candidal multiple sites infection. Renal abscess is a rare form of disseminated candidal infection in neutropenic

References (10)

  • P.M. Flynn et al.

    Candida tropicalis infections in children with leukemia

    Leukemia Lymphoma

    (1993)
  • A. Rantala et al.

    Diagnostic factors for postoperative candidiasis in abdominal surgery

    Ann Chirurg Gynaecol

    (1991)
  • S. Schelenz et al.

    Candidemia in a London teaching hospital: analysis of 128 cases over 7-year period

    Mycoses

    (2003)
  • J.R. Cabello et al.

    Magnetic resonance imaging in the evaluation of inflammatory lesions in muscular and soft tissues: an experimental infection model induced by Candida albicans

    Magn Res Imaging

    (1999)
  • A. Lupetti et al.

    Technectium-99m labeled fluconazole and antimicrobial peptides for imaging of Candida albicans and Aspergillus fumigatus infection

    Eur J Nuc Med

    (2002)
There are more references available in the full text version of this article.

Cited by (18)

  • Candida albicans causing cervical pyomyositis: A case report

    2020, Acta Otorrinolaringologica Espanola
  • How long should we treat Candida albicans pyomyositis? Insight from a cured case

    2020, Journal of Microbiology, Immunology and Infection
  • Purulent infectious myositis (formerly tropical pyomyositis)

    2020, Journal of the Neurological Sciences
  • Infectious myositis in children

    2014, Pediatria Polska
  • Primary retroperitoneal abscess caused by Candida glabrata

    2012, American Journal of the Medical Sciences
    Citation Excerpt :

    Candida parapsilosis has been reported as the microbiological cause of a retroperitoneal abscess obstructing the superior mesenteric artery.8 Candida albicans has been associated with pyomyositis with hepatic and perinephric abscess in diabetic patients.9 To the best of our knowledge, there is no report of C glabrata causing primary retroperitoneal abscess in the literature.

  • Pyomyositis

    2011, Neuroimaging Clinics of North America
    Citation Excerpt :

    Streptococci (groups B, C, and G), Pneumococcus, Neisseria, Haemophilus, Aeromonas, Pseudomonas, Klebsiella, and Escherichia have also been implicated, albeit uncommonly.6,16,28–30 Mycobacteria (M avium complex, M Tuberculosis, and M haemophilium), fungi (Blastomycosis, Cryptococcus neoformans, Aspergillus, Candida, Fusarium, Pneumocystis Jiroveci), and anaerobes (Salmonella, Vibrio, Enterococci, Capnocytophaga sputigena, Stenotrophomonas maltophilia, and Burkholderia cenocepacia) remain subjects of anecdotal case reports.12,14,31–45 Chiu and colleagues46 reported a higher incidence of gram-negative bacterial pyomyositis in patients with underlying diseases.

View all citing articles on Scopus
View full text