Acute bilateral pyelonephritis

Case contributed by Bita Abbasi
Diagnosis almost certain

Presentation

A young woman presenting with fever, chills and abdominal pain.

Patient Data

Age: 20 years
Gender: Female

Multiple hypoenhancing areas in both kidneys, giving striated nephrogram appearance. The hypoenhancing regions involve the cortical rim, a feature differentiating them from acute cortical necrosis (rim sign). Also, note the perinephric fat stranding. 

Case Discussion

Acute pyelonephritis generally involves a single kidney. Bilateral involvement is uncommon and presents with more severe symptoms.

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