Presentation
Left flank swelling, pain and fever for 2 weeks.
Patient Data
Large multi-loculated peripherally enhancing collection at the left posterior pararenal space with extension to the subcutaneous tissue of left flank. It is associated with significant fat stranding.
Anteriorly, it abuts the left posterior pararenal fascia and left perinephric space as well as the posterior aspect of left kidney. It displaces the left kidney anteriorly without clear plane of demarcation between them. Medially, minimal extension to the left psoas muscle.
No bony erosion.
A few left simple renal cortical cysts. No hydronephrosis or hydroureter.
No ascites. No abdominal or pelvic lymphadenopathy.
Case Discussion
On admission, patient had raised inflammatory/infective markers (high CRP, high white blood cell count). Ultrasound guided pigtail catheter drainage performed to the left retroperitoneal abscess. Pus culture isolated Escherichia coli.
The admission urine biochemistry showed evidence of urinary tract infection (nitrite positive and presence of leukocytes). Urine culture also isolated E. coli.
Patient has uncontrolled diabetes mellitus which high blood glucose reading. Diabetic patients are prone to developing abscesses.
Patient was discharged well after one week of drainage and intravenous antibiotic (ampicillin) which was sensitive to the pathogen.
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