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Renal Mucormycosis in an AIDS Patient: Imaging Features and Pathologic Correlation

Ciaran F. Keogh1, Jacqueline A. Brown1, Peter Phillips2 and Peter L. Cooperberg1

1 Department of Radiology, St. Paul's Hospital, 1081 Burrard St., Vancouver, B. C., V6Z 1Y6 Canada.
2 Infectious Disease Clinic, St. Paul's Hospital, Vancouver, B. C.m V6Z 1Y6 Canada.



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  		Fig. 1A. —35-year-old woman with left flank pain who was HIV-positive and had history of IV drug abuse. Contrast-enhanced axial CT scan acquired through upper pole of left kidney shows upper caliceal hydronephrosis (arrow) and heterogeneous enhancement with numerous small hypodensities throughout renal parenchyma.

 


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  		Fig. 1B. —35-year-old woman with left flank pain who was HIV-positive and had history of IV drug abuse. Contrast-enhanced axial CT scan acquired through lower pole of the left kidney shows large hypodense area (arrow) corresponding to abscess.

 


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  		Fig. 1C. —35-year-old woman with left flank pain who was HIV-positive and had history of IV drug abuse. Axial T1-weighted MR image acquired through mid kidneys shows that left kidney is enlarged and hypointense relative to right. Focal hypointensity (arrow) represents dilated collecting system.

 


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  		Fig. 1D. —35-year-old woman with left flank pain who was HIV-positive and had history of IV drug abuse. Axial T2-weighted MR image of left kidney shows marked heterogeneity and confluent hypointensities throughout parenchyma. At histology (not shown), these findings corresponded to noncystic infarction and fungus-filled abscesses. Focal caliceal dilatation (arrow) is also present.

 


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  		Fig. 1E. —35-year-old woman with left flank pain who was HIV-positive and had history of IV drug abuse. Axial nondynamic spin-echo T1-weighted MR image obtained after gadolinium administration shows generalized decreased enhancement in left kidney relative to right. Hypointense areas seen on T2-weighted MR images (not shown) did not enhance, confirming presence of infarction and necrosis.

 


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  		Fig. 1F. —35-year-old woman with left flank pain who was HIV-positive and had history of IV drug abuse. Photograph of bisected nephrectomy specimen in coronal view shows infarcted lower pole replaced by abscess and multiple small abscesses throughout remainder of kidney.

 

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