Pyelonephritis

Case contributed by A.Prof Frank Gaillard

Presentation

Sepsis of unknown origin being treated in ICU. Source of sepsis?

Patient Data

Age: 70
Gender: Female
CT

The left kidney is somewhat swollen, enhances less than the right, and demonstrates extensive surrounding stranding. Although the collecting system is a little prominent, with enhancing mucosa, no ureterolithiasis can be identified (a few pelvic phleboliths can be seen to be separate from the ureter on the MPR of the thin slices - not shown). No abscess is identified, although both kidneys demonstrate cortical scars, presumably related to prior (paediatric) reflux.

Case Discussion

Pyelonephritis usually presents with loin pain, however in the elderly, localising signs are often absent. It is crucial to ensure the collecting system is not obstructed as an infected obstructed kidney needs urgent drainage. 

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Case information

rID: 28838
Case created: 15th Apr 2014
Last edited: 28th Oct 2015
System: Urogenital
Inclusion in quiz mode: Included

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