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.