Acute suppurative pyelonephritis

Case contributed by Dr Hani Makky Al Salam

Presentation

Diabetic patient with left flank pain, fever and hematuria for 3 days duration, not responding to medical treatment.

Patient Data

Age: 30 years
Gender: Female
X-ray

Enlarged left renal outline.

Left renal enlargement, with patchy or striated nephrogram and cortical wedge-shaped areas of decreased density. There is a loss of normal corticomedullary differentiation with multiple peripheral and cortical abscesses. There is a thickening of the walls of the renal pelvis, calyces and proximal ureter with abnormal enhancement.

Excretory phase demonstrates streaky linear bands of alternating high and low attenuation.

Case Discussion

Acute suppurative pyelonephritis in a diabetic patient.

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