Acute pyelonephritis

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Fever, left flank pain and costovertebral angle tenderness on physical exam.

Patient Data

Age: 60 years
Gender: Female
ct

The left kidney is enlarged and diffusely altered in attenuation compared to the normal right kidney. This is accompanied by perinephric fat stranding, mild urothelial thickening, and several enlarged para-aortic lymph nodes with SAD less than 14 mm. Findings are consistent with left-sided pyelonephritis.

No micro-abscess and no perinephric fluid collection could be noted.

Case Discussion

This case demonstrates an early-stage non-complicated acute pyelonephritis. The patient was treated with intravenous antibiotics, analgesia and antipyretics with good clinical response.

It should be noted that even when imaging has been performed, no follow-up imaging is usually required unless patients do not respond clinically, and it should be stressed that imaging changes can take up to five months to resolve.

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