Presentation
We report an unusual presentation of a pancreatic pseudocyst in a young male who presented with a left perinephric abscess. [ncbi.nlm.nih.gov]
Entire Body System
-
Fever
Fever was documented before diagnosis in 88% of patients. Abdominal mass (13%) or tenderness (49%), and flank mass (9%) or tenderness (42%) were seen less frequently, and 11% of patients did not have fever, flank, or abdominal findings. [ncbi.nlm.nih.gov]
-
Chills
Fever (55%), chills or diaphoresis (47%), flank pain (40%), abdominal pain (40%), and nausea or vomiting (32%) were the most common presenting symptoms. About half the patients had symptoms for 1 week or less and 12% had no symptoms. [ncbi.nlm.nih.gov]
Other risk factors for perirenal abscess include: Diabetes Having an abnormal urinary tract Trauma Symptoms Symptoms of perirenal abscess include: Chills Fever Pain in the flank (side of the abdomen) or abdomen, which may extend to the groin or down the [dxline.info]
Other risk factors for perirenal abscess include: Diabetes Having an abnormal urinary tract Trauma IV drug use Symptoms of perirenal abscess include: Chills Fever Pain in the flank (side of the abdomen) or abdomen, which may extend to the groin or down [medlineplus.gov]
The following case represents an unusual localization of infection with this organism.A 37-year-old married man had pain in the left flank for two weeks and shaking chills for three days. [nejm.org]
-
Malaise
Diabetes mellitus, fever, malaise and pain in the left flank.Left hydronephrosis secondary to obstruction by proximal ureteral calculi. [slideshare.net]
Patients, typically middle-aged /elderly males, present with non-specific symptoms, such as fever, malaise, and weight loss. Right upper quadrant pain and tender hepatomegaly are specific features of a liver abscess but are often absent. [amboss.com]
Synonym: cerebral abscess ; intracranial abscess Symptoms Symptoms may include headache, fever, vomiting, malaise, irritability, seizures, or paralysis. Treatment The usual treatment is chemotherapy. [medical-dictionary.thefreedictionary.com]
Malaise, nausea, vomiting, anorexia and occasionally diarrhoea occur. There may or may not be accompanying lower urinary tract symptoms with frequency, dysuria, gross haematuria or hesitancy. [patient.info]
Constitutional symptoms : chills, malaise, anorexia and weight loss. Abdominal pain : Not localized due to the unusual site of the abscess. [wikidoc.org]
-
Flank Mass
Abdominal mass (13%) or tenderness (49%), and flank mass (9%) or tenderness (42%) were seen less frequently, and 11% of patients did not have fever, flank, or abdominal findings. [ncbi.nlm.nih.gov]
A flank mass is palpable if the abscess is large or located in the inferior pole of the kidney space (9-47%). A renal malignancy must be ruled out in these patients with appropriate radiographic studies (eg, CT scanning, MRI). [emedicine.medscape.com]
Gastrointestinal
-
Abdominal Pain
Despite immunosuppression, signs and symptoms of perinephric abscess were prominent and included fever, flank and abdominal pain and tenderness, and abdominal mass. [ncbi.nlm.nih.gov]
pain, vomiting and diarrhoea for seven days. [veterinaryrecord.bmj.com]
-
Right Flank Pain
A 53-year-old Chinese premenopausal woman presented with intermittent right flank pain for many years. Imaging studies revealed a contracted non-functioning right kidney and a perinephric abscess. [ncbi.nlm.nih.gov]
A 69-yr-old woman presented to our emergency room with severe right flank pain that had developed one week earlier. She also complained of anuria for three days. [synapse.koreamed.org]
flank pain, tactile fever, chills, nausea, anorexia, and a single episode of hematuria. [aafp.org]
-
Abdominal Mass
Despite immunosuppression, signs and symptoms of perinephric abscess were prominent and included fever, flank and abdominal pain and tenderness, and abdominal mass. [ncbi.nlm.nih.gov]
A palpable flank or abdominal mass is present in about half of the cases. The mass may be better appreciated by examination of the patient in the knee–chest position. There may also be signs of psoas muscle irritation with flexion of the thigh. [urologysurgery.wordpress.com]
-
Left Flank Pain
Case Report A 43-year-old female, with left renal stone, presented to our hospital after two days of fever and left flank pain. [ijcasereportsandimages.com]
-
Chronic Diarrhea
We report an unusual case of a patient with a perinephric abscess who presented with chronic diarrhea and weight loss. [ncbi.nlm.nih.gov]
Cardiovascular
-
Tachycardia
Physical exam for both acute pyelonephritis and perinephric abscess is usually positive for the following: fever, tachycardia, tenderness over the costoverterbral angles and abdomen on deep palpation. [clinicaladvisor.com]
Symptoms of Renal Abscess Weight loss Discomfort Specific Symptoms of Renal Abscess Fever with chills Uncontrollable shaking or shivering Temperature- 112 to 104 0 F Excessive Sweating Abdominal Pain Painful Urination Bloody Urine Hypotension Pale Skin Tachycardia [epainassist.com]
In advanced cases with septicemia, the patient may be drowsy with decreased level of consciousness. [1] Vital signs Fever Tachycardia Tachypnea Hypotension (if patient is presenting with shock ) Abdominal Examination Abdominal tenderness is often present [wikidoc.org]
Signs of sepsis (eg, tachypnoea, tachycardia, hypotension). Dehydration or inability to take fluids/medication. Severe pain or debility. Failure of response to treatment in primary care within 24 hours. [ 8 ] Urinary tract obstruction. [patient.info]
The initial evaluation revealed high fever (body temperature 39.7 C), tachycardia (heart rate, 112 beats per minute), leukocytosis (white blood cell, 24,560 per micrometer) with a left shift of elevated C-reactive protein (18.98 mg/dL), and left flank [ijcasereportsandimages.com]
Skin
-
Ecthyma
Persistent bacteremia resulted in the development of ecthyma gangrenosum, which has not previously been associated with Klebsiella spp infection. [nebraska.pure.elsevier.com]
-
Vesicular Rash
On day 12 a vesicular rash appeared on the neck and herpes simplex virus 1 (HSV-1) grew on culture. On day 15 an upper leg collection was seen on CT scan. [ncbi.nlm.nih.gov]
Urogenital
-
Flank Pain
Author information 1 Emergency Department, East Surrey Hospital, Redhill, Surrey, United Kingdom. [email protected] Abstract Perinephric abscesses often present with flank pain and signs of sepsis, and are known to discharge to the skin. [ncbi.nlm.nih.gov]
Patients present usually with symptoms of more than one week, complaining about fever, flank pain or abdominal pain, night sweat and chills. More than 30% are afebrile. [urology-textbook.com]
Workup
Initial ED diagnostic workup included a hemogram that showed marked leukocytosis with neutrophilia (WBC: 36,100/mm 3 and ANC: 20,700/mm 3 ) and normocytic, hypochromic anemia (hemoglobin 9.1 g/dL, MCV 64 and MCH 21). [healio.com]
X-Ray
-
Pulmonary Infiltrate
Nephrobronchial fistula, while a rare complication of perinephric abscess, should be considered when a patient presents with perirenal suppurative process and chest x-ray findings consistent with pleural effusion or pulmonary infiltrates. [ncbi.nlm.nih.gov]
Microbiology
-
Streptococcus Pneumoniae
A patient is reported who developed perinephric abscess (Streptococcus pneumoniae) at the site of a renal biopsy performed five years earlier. Wisdom tooth impaction and extraction occurred shortly after the biopsy. [ncbi.nlm.nih.gov]
pneumonia. [4], [5] There are only few case reports of perinephric abscess due to Salmonella species in the literature. [jcrsmed.org]
One case caused by Streptococcus pneumoniae infection has been reported. [2] Anaerobes such as Clostridium, Bacteroides, and Actinomyces may account for some of the culture-negative abscesses. [emedicine.medscape.com]
-
Fusarium
We report a rare case of perinephric abscess caused by Fusarium chlamydosporum in a child who had a recent episode of pyelonephritis. [ncbi.nlm.nih.gov]
Treatment
Treatment utilized both percutaneous drainage and open surgery. Perinephric abscesses have not been previously reported to extend into the spleen. [ncbi.nlm.nih.gov]
Cost for treatment Diagnostic tests for perinephric abscess Perinephric abscess treatment with open surgery drainage Perinephric abscess treatment with percutaneous drainage University Hospital of Ludwig Maximilian University of Munich 10 / 10 from 40 [bookinghealth.com]
The treatment of acute pyelonephritis can be divided into inpatient and outpatient treatment. [clinicaladvisor.com]
Prognosis
Treatment and prognosis Perinephric and mixed perinephric/renal abscesses are typically treated with imaged guided percutaneous drainage. [radiopaedia.org]
(Outcomes/Resolutions) In most cases, an immediate diagnosis and suitable treatment of Perirenal Abscess will result in good prognosis Any case of kidney stones must be treated promptly, because it is the biggest risk factor that may lead to Perirenal [dovemed.com]
Twelve months after surgery the dog remains clinically stable, but owing to the disease of its remaining kidney its long-term prognosis is poor. [veterinaryrecord.bmj.com]
Outlook (Prognosis) In general, quick diagnosis and treatment of perirenal abscess should lead to a good outcome. Kidney stones must be treated to avoid further infections. [dxline.info]
Prognosis Worse outcomes with Diabetes Mellitus, large abscess, advanced age, Renal Insufficiency XI. Complications Septic Shock Fistula formation (e.g. Small Bowel) Renal Hemorrhage Contiguous spread (e.g. Pneumonia, peritoneal spread) XII. [fpnotebook.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Candida and Torulopsis species are the reported etiologic agents. Successful therapy usually consists of percutaneous or surgical drainage of the abscess. [ncbi.nlm.nih.gov]
Epidemiology
Clinical, epidemiological, and microbiological profile of patients with vancomycin-resistant enterococc from a tertiary care hospital. J Glob Infect Dis 2012;4:137-8. 3. Saadat S, Solhjoo K, Norooz-Nejad MJ, Kazem A. [jacmjournal.org]
Epidemiology References: [1] [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Epidemiology and infection. 139(2):229-35. 2011. [ pubmed ] Coelho RF, Schneider-Monteiro ED, Mesquita JL, Mazzucchi E, Marmo Lucon A, Srougi M. Renal and perinephric abscesses: analysis of 65 consecutive cases. [ultrasoundoftheweek.com]
Epidemiology Frequency Perinephric abscess is an uncommon complication of urinary tract infections. The incidence ranges from 1-10 cases for every 10,000 hospital admissions. Men and women are affected with equal frequency. [emedicine.medscape.com]
[…] tract ) Multibacterial & anaerobes (if gastrointestinal tract (GIT) is the primary source) Staphylococcus aureus (if from distant septic focus ) Tuberculosis (if secondary to Pott’s disease ) Differentiating retroperitoneal abscess from other Diseases Epidemiology [wikidoc.org]
Pathophysiology
We review similar cases in the literature and discuss pathophysiology and current management of perinephric abscesses. [ncbi.nlm.nih.gov]
Brenner/Rector remains the go-to resource for practicing and training nephrologists and internists who wish to master basic science, pathophysiology, and clinical best practices. [books.google.com]
Leukocytosis is usually not extremely high (between 10,000 and 20,000 in most cases) Blood culture is not always positive (but carries a grave prognosis if positive).Organism depends on the source of abscess as mentioned above in pathophysiology. [wikidoc.org]
Pathophysiology Perinephric abscesses are located between the capsule of the kidney and the Gerota fascia. The abscesses remain confined in this location because of the Gerota fascia. [emedicine.medscape.com]
[…] warmth at the margins of the incision with purulent drainage from it. [19] If the diagnosis is uncertain, the wound should be aspirated with a needle, with aspiration of pus confirming the diagnosis and availing for Gram stain and bacterial culture. [19] Pathophysiology [en.wikipedia.org]
Prevention
Since the extent of the disease may not be apparent radiologically, and often is only ascertained at the time of surgery, we recommend an aggressive approach to renal calculi as the most effective means of preventing complicated perinephritis. [ncbi.nlm.nih.gov]
Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.ro]