Pyelonephritis with renal abscesses

Case contributed by Dr Dmitry Gebel

Presentation

Right flank pain, fever, malaise for four days.

Patient Data

Age: 30 years
Gender: Female
Ultrasound

Poor corticomedullary differentiation and multiple focal irregular areas of parenchymal hypoechogenicity in the right kidney.

Sagittally malrotated right kidney with multiple T2W hypointense and T1W relatively hyperintense foci showing restricted diffusion.

On surgical evaluation there are multiple abscesses ranging from 0.1-4.0 cm.

Case Discussion

Pyelonephritis does not normally require imaging confirmation, but a suspicion for renal abscess is an indication for advanced imaging.

Typically, treatment is a combination of antibiotics +/- percutaneous drainage of abscess(es). Surgical exploration may be necessary if there is a high risk complicating factor (e.g. emphysematous pyelonephritis) or if conservative therapies have failed to control the infection.

Thanks to Dr GM Adenova for contributing this case.

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Case information

rID: 61538
Published: 19th Jul 2018
Last edited: 11th Sep 2019
System: Urogenital
Tag: kidney
Inclusion in quiz mode: Excluded
Institution: Almaty medical University

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