Candidal renal papillary necrosis conquered.

Renal papillary necrosis due to Candida albicans is a rare but treatable cause of acute renal failure. We report this case of a middle aged male with history of type 2 diabetes mellitus who presented with infected right lower extremity and right lower lobe pneumonitis with hypotension. Though, he improved initially, during his stay in the hospital, he developed acute renal failure. Blood culture grew Candida albicans and the renal biopsy revealed candidal renal papillary necrosis. He also had candidal retinitis on ophthalmoscopy examination. He was treated with parenteral fluconazole for two weeks followed by oral fluconazole for a total of 4 weeks. Following treatment, the patient improved symptomatically and his renal parameters returned to normal. This case illustrates the need to consider candidal papillary necrosis as a differential in an immunocompromised patient with acute renal failure. It is potentially reversible, nonetheless a diagnostic and therapeutic challenge.

Disseminated histoplasmosis in an AIDS patient: a rare case from southern India.

We present a case of disseminated histoplasmosis with acquired immunodeficiency syndrome (AIDS). A 38-year-old woman presented with fever, cough, dysphagia, significant weight loss and a loss of appetite. She also suffered from anaemia and cervical lymphadenopathy. A lymph node biopsy and a bone marrow aspirate showed intracellular yeast forms of Histoplasma capsulatum. She improved with parenteral amphotericin B and oral itraconazole. Even though histoplasmosis is not endemic in South East Asia and India, it should be kept in mind when evaluating AIDS patients in view of the current scenario of the pandemic.