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Renal And Perinephric Abscess

 Syn. Renal and perinephric suppurations , Renal carbuncle , Multiple miliary renal abscesses

Signs & Symptoms

 Fever
Note: Insidious onset
Ref: Uptodate [ Renal and perinephric abscess] Harrison [ 958] Harrison [ p958]
Costovertebral angle tenderness
Ref: Uptodate [ Renal and perinephric abscess]
Chills
Ref: Uptodate [ Renal and perinephric abscess]
Lumbo-abdominal pain
Ref: Uptodate [ Renal and perinephric abscess] Harrison [ 958]

Physical Examination

 Costovertebral angle tenderness
Ref: Uptodate [ Renal and perinephric abscess]
Pallor
Ref: Uptodate [ Renal and perinephric abscess]
Fatigue
Ref: Uptodate [ Renal and perinephric abscess]

Lab / Serology

 Polymicrobial urine culture
Ref: Harrison [ 958]
Sterile urine culture
Note: Fever and pyuria with sterile urine culture
Ref: Harrison [ 958]
Acidosis
Note: Common early finding in diabetics
Ref: Uptodate [ Renal and perinephric abscess]

Imagin Study

 Thick-walled cavity filled with fluid
Ref: Uptodate [ Renal and perinephric abscess]
Intrarenal walled-off cavities
Note: due to renal abscess
Ref: Uptodate [ Renal and perinephric abscess]
Scoliosis with concavity toward the lesion
Ref: Uptodate [ Renal and perinephric abscess]

Complication

 Lung abscess
Ref: Uptodate [ Renal and perinephric abscess]
Nephrobronchial fistula
Ref: Uptodate [ Renal and perinephric abscess]
Liver abscess
Ref: Uptodate [ Renal and perinephric abscess]

Risk Factors

Cause

 Pyelonephritis
Note: Those who do not or are slow to respond to antimicrobial therapy
Ref: Uptodate [ Renal and perinephric abscess] Harrison [ 958]

Other