A RARE CASE OF RENAL MUCORMYCOSIS WITH MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MISC) IN PATIENT OF T- CELL ACUTE LYMPHOBLASTIC LEUKEMIA (T -ALL) : CASE REPORT

Abstract

Background: Mucormycosis is a rare Angioinvasive, opportunistic fungal infection occurring most often in immunocompromised patients with reported mortality rate of 95% in disseminated cases9. The most common clinical presentation of infection with the fungus is rhinocerebral, followed by primary pulmonary, disseminated, gastrointestinal and cutaneous manifestations, whereas Renal Mucormycosis is a manifestation of disseminated diseases(10,11). Since, isolated renal Mucormycosis is extremely rare, and there are only few case reports describing the isolated renal Mucormycosis in literature. Clinical Description: We report a case of immunocompromised child with T cell ALL, presenting as high grade fever with abdominal pain and respiratory distress, who underwent nephrectomy for renal gangrene, Histopathological examination of which revealed mucormycosis and other relevant investigations suggestive of MISC. Management: Patient was initially managed with nephrectomy and higher antibiotics, followed by IVamphotericin B, and IVIG for MISC, but later succumbed to illness. Conclusion:Ahigh index of suspicion with multidisciplinary treatment approach involving early institution of pertinent antifungal therapy, addressing underlying other comorbidities, and, where possible, surgical debridement of debilitate tissue is obligatory to achieve therapeutic success.