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Acute bilateral pyelonephritis

Case contributed by Domenico Nicoletti
Diagnosis almost certain

Presentation

Patient with fever and chills, left side pain, leukocytosis with increasing creatinine. Ultrasound abdomen: fatty liver with normal kidneys.

Patient Data

Age: 20 years
Gender: Female

Enlargement of both kidneys with heterogeneous parenchymal enhancement and multiple partially confluent hypoattenuating areas with blurred margins. There is a small cortical cyst at the lower pole of the left kidney.

Marked fatty liver.

Radiographer: TSRM Fabius Imola

Case Discussion

Acute pyelonephritis may be focal or diffuse. The pathogenesis is usually bacterial and ascending from the bladder.

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