Fungal papillary necrosis with the “ring sign”

A 35-year-old man with no comorbidities presented with a fever of 100 °F, vomiting, and low backache of 3 days’ duration. Examination revealed a soft abdomen with tenderness in the left renal angle. Laboratory investigations showed a raised total leukocyte count of 12,500 cells/mm3 with a differential of polymorphs of 85%, lymphocytes of 15%, and serum creatinine l evel of 4.3 mg/dl. Urine examination was positive for leukocyte esterase and nitrites with 50 to 60 white blood cells per high-power field.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Nephrology Image Source Type: research