Introduction
Mucormycosis in the urinary bladder is extremely rare with only one case
reported in the literature. [1]
Mucormycosis of the urinary bladder is usually associated with renal
mucormycosis. Risk factors for mucormycosis are diabetes mellitus,
chronic kidney disease, malignancies, immunosuppressive therapy, and
recently Covid 19 infection, etc. [2]
It is caused by fungi of order Mucorales which includes several species.
It causes infection in immunocompromised patients however occasionally
in immunocompetent patients. [3]
We present a case of 55 years diabetic patient with fever, difficulty in
urination and deranged creatnine ultimately diagnosed with urinary
bladder mucormycosis.
Case summary A 55 years male presented with low-grade fever,
dysuria, flank pain and obstructive urinary symptoms. He was a known
diabetic on oral hypoglycaemic drugs. He has no history of dyspnoea,
chest pain, facial pain, recent Covid 19 infection, or intake of any
immunosuppressive therapy. On clinical examination abdomen was normal,
the renal angle was nontender. Blood investigation were Hemoglobin 12.5,
TLC 11500/mm3, Urea 35, creatinine 2.5 mg/dl, electrolytes were normal.
Ultrasound and Noncontrast CT scan abdomen was suggestive of right mild
hydronephrosis with thickened urinary bladder filled with internal
echoes. Figure 1. Cystoscopy was planned because of hydronephrosis and
echogenic contents in the urinary bladder which revealed whitish to
yellowish necrotic material in the urinary bladder. Figure 2 Evacuation
of necrotic material was done and sent for histopathology. The
histopathologic examination of the necrotic material was suggestive of
Mucormycosis and aspergillosis. Figure 3. He was started on Posaconazole
and improved.