Presentation
Fever, loin pain, and leukocytosis were common presenting features, but less than half of all abscesses were associated with either an abnormal urinalysis or a positive urine culture. [ncbi.nlm.nih.gov]
Entire Body System
- Fever
Renal abscess is uncommon in pediatrics and is rarely a cause of fever of unknown origin. We recently cared for a patient who presented with a 3-week history of fever. An indium scan ultimately led to the diagnosis of a renal abscess. [ncbi.nlm.nih.gov]
- High Fever
Abstract Renal abscesses are uncommon in children, and usually present with a high fever and flank pain. We report a 9-year-old girl who presented with abdominal pain and cough. [ncbi.nlm.nih.gov]
- Weight Loss
Other symptoms are nausea, malaise and weight loss. Psoas muscle abscess may be classified as primary or secondary depending on the presence or absence of underlying disease. [radiopaedia.org]
Nonspecific constitutional symptoms (eg, malaise, fatigue, weight loss) may occur in patients with xanthogranulomatous pyelonephritis (XGP). [emedicine.medscape.com]
Signs and Symptoms of a Renal Abscess Fever and chills Flank pain or abdominal pain Weight loss, malaise Urosepsis Kidney Abscess: Diagnostic Work-Up Urine culture: Urine culture can often isolate the responsible bacteria and is needed for antibiotic [urology-textbook.com]
Patients with renal abscesses may present with clinical pyelonephritis symptoms such as fever, nausea, weight loss, dysuria, malodorous urine, abdominal or flank pain. [pediatriceducation.org]
Patients with renal abscesses may present with nonspecific constitutional symptoms, such as fever, general malaise, nausea, decreased appetite, and weight loss. [healio.com]
- Malaise
Other symptoms are nausea, malaise and weight loss. Psoas muscle abscess may be classified as primary or secondary depending on the presence or absence of underlying disease. [radiopaedia.org]
Nonspecific constitutional symptoms (eg, malaise, fatigue, weight loss) may occur in patients with xanthogranulomatous pyelonephritis (XGP). [emedicine.medscape.com]
Signs and Symptoms of a Renal Abscess Fever and chills Flank pain or abdominal pain Weight loss, malaise Urosepsis Kidney Abscess: Diagnostic Work-Up Urine culture: Urine culture can often isolate the responsible bacteria and is needed for antibiotic [urology-textbook.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]
Patients with renal abscesses may present with nonspecific constitutional symptoms, such as fever, general malaise, nausea, decreased appetite, and weight loss. [healio.com]
- Recurrent Urinary Tract Infection
We report a 15-year-old girl with a history of recurrent urinary tract infections who developed a right renal abscess. Percutaneous abscess drainage and subsequent microbiological culture revealed CA-ESBL Escherichia coli. [ncbi.nlm.nih.gov]
Most patients with renal corticomedullary abscess have a history of recurrent urinary tract infections, renal calculi, and/or prior genitourinary tract instrumentation. Urinary tract obstruction is an important predisposing factor. [emedicine.medscape.com]
tract infections) Diagnosis [ edit ] Laboratory examination [ edit ] Analysis of the urine may show signs of urinary tract infection. [en.wikipedia.org]
Gastrointestinal
- Abdominal Pain
Abstract Renal abscess is rare in children and the usual presenting features include fever, lumbar pain, abdominal pain and occasional flank mass. Renal ultrasonography facilitates an early diagnosis and helps in percutaneous drainage. [ncbi.nlm.nih.gov]
- Failure to Thrive
There may be features of acute or recurrent infection, or of complications of significant renal damage: Fever Malaise Loin pain Nausea Vomiting Dysuria Hypertension Failure to thrive Features of CKD Investigations Urine microscopy, culture and sensitivity [patient.info]
Cardiovascular
- Hypertension
Renal scarring may lead to hypertension, renal insufficiency and potential failure. [pediatriceducation.org]
Secondary hypertension. Pyonephrosis. Focal glomerulosclerosis. Urea-splitting organisms can lead to staghorn calculi - the usual culprit is Proteus spp. [patient.info]
Skin
- Night Sweats
He had intermittent high fevers to 103°F, along with chills and night sweats for 7 days. Upper respiratory symptoms, including nasal congestion and cough, were noted for a few days. [healio.com]
Urogenital
- Flank Pain
Flank Pain… Flank pain for several days, history of nephrolithiasis: This patient has marked right hydronephrosis with significant right renal perinephric inflammatory cystic changes extending into the contiguous right psoas musculature and right retroperitoneum [emrems.com]
We emphasize the need to obtain an abdominal ultrasound scan and computed tomography scan in patients with abdominal or flank pain, and laboratory evidences of infection to avoid diagnostic and therapeutic delays. [ncbi.nlm.nih.gov]
- Dysuria
Risk factors The predisposing factors include 4 : diabetes mellitus renal calculi ureteral obstruction The most common signs or symptoms are : fever flank/abdominal pain chills dysuria Ultrasound Typically, a renal abscess appears as a well-defined hypoechoic [radiopaedia.org]
Symptoms of UTI (dysuria, frequency) are not common manifestations of both types of abscesses. Choice of antibiotic therapy is generally targeted towards gram negative coverage (unless concern for hematogenous spread of staphylococcus is high). [ucsfmed.wordpress.com]
Review of systems was negative for localized pain, irritability, skin rash, conjunctivitis, dysuria, or choluria. He was still catching up with immunizations. [healio.com]
Patients with renal abscesses may present with clinical pyelonephritis symptoms such as fever, nausea, weight loss, dysuria, malodorous urine, abdominal or flank pain. [pediatriceducation.org]
Some individuals with renal corticomedullary abscess develop dysuria and other urinary tract symptoms. Nonspecific constitutional symptoms (eg, malaise, fatigue, weight loss) may occur in patients with xanthogranulomatous pyelonephritis (XGP). [emedicine.medscape.com]
- Hematuria
Symptoms of Cystitis are chief complaint - A strong, persistent urge to urinate -A burning sensation when urinating -Passing frequent, small amounts of urine -Blood in the urine (hematuria) -Passing cloudy or strong-smelling urine -Discomfort in the pelvic [quizlet.com]
Today we discussed the case of a young man presenting with RLQ/flank pain and hematuria, found on imaging to have a renal abscess vs mass! We had an interesting discussion on renal vs perinephric abscesses. [ucsfmed.wordpress.com]
Moreover, the blood cultures yielded Escherichia coli and hematuria without pyuria were noted. [ijcasereportsandimages.com]
[…] older than 50 years • Underlying condition compromising immune system: Diabetes, immunosuppression, chronic debilitating disease • Symptoms of urinary tract infection Fever, irritative voiding symptoms, flank pain • Symptoms of bladder irritability & hematuria [slideshare.net]
Urinalysis – positive for signs of pyuria which include nitrites and leukocyte esterase, can be positive for hematuria (nitrites are only present when infections are caused by the Enterobacteriaceae). [clinicaladvisor.com]
Workup
This workup should include preoperative imaging to define the extent of the parenchymal process (see Imaging Studies). [emedicine.medscape.com]
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
- Nephrolithiasis
Ascending urinary tract infections (pyelonephritis), tubular obstruction and nephrolithiasis are common risk factors for a renal abscess. Perinephric abscess may result from the rupture of a renal abscess with cortical location. [urology-textbook.com]
Flank Pain… Flank pain for several days, history of nephrolithiasis: This patient has marked right hydronephrosis with significant right renal perinephric inflammatory cystic changes extending into the contiguous right psoas musculature and right retroperitoneum [emrems.com]
Obstruction – nephrolithiasis, increased post void residual, neurogenic bladder 2. Immunosuppression – diabetes, renal transplant, steroid use 3. Metabolic – nephrolithiasis 4. [clinicaladvisor.com]
[…] pelvicaliectasis filled with reflective material in a patient with ureteropelvic junction obstruction Infection: Tuberculosis of the left kidney with inhomogeneous renal sinus, calcifications and irregular thickening of the ureter and mild caliectasis Infection: Nephrolithiasis [ultrasoundcases.info]
Management of lower pole nephrolithiasis: A critical analysis. J Urol 1994 Mar;151(3):663–7. [ Pubmed ] Goldberg S, Coyne D. Renal diseases: Nephrolithiasis. In: HemantGodara, eds. The Washington Manual of Medical Therapeutics, 34RD edition. [ijcasereportsandimages.com]
Urine
- Pyuria
Purulent urine, pyuria, bacteriuria, and bacteremia were noted after admission. Renal abscess was diagnosed by percutaneous needle aspiration under computerized tomography guidance. [ncbi.nlm.nih.gov]
Pyuria (pus in urine) 4. Progressive renal failure 5. Pain due to ureteral colic 6. [quizlet.com]
Moreover, the blood cultures yielded Escherichia coli and hematuria without pyuria were noted. [ijcasereportsandimages.com]
Serum
- Neutrophilia
Leukocytosis with neutrophilia is usually present. Urinalysis may reveal pyuria, but urine culture is often negative. [healio.com]
2015 came to the conclusion that although procalcitonin seemed the most helpful, there was not enough evidence to recommend routine use of any of these blood tests in clinical practice at this time. [ 5 ] FBC : this shows elevated white cell count with neutrophilia [patient.info]
Blood tests such as a complete blood count may show neutrophilia. [en.wikipedia.org]
Laboratory
- Leukocytosis
Renal abscesses must be suspected in children with loin pain, fever and leukocytosis. They may heal even without hospitalization and drainage. [ncbi.nlm.nih.gov]
Presentation A 29 year old female presents with fever, flank pain, leukocytosis and leukocyturia. [sonoworld.com]
Treatment
A treatment algorithm is reported. [ncbi.nlm.nih.gov]
Prognosis
Clinical factors were also analyzed for their value in predicting poor prognosis. The mean age of 88 patients with renal abscess was 59.8 years. [tmu.pure.elsevier.com]
The purpose of this study is to demonstrate the clinical characteristics of K pneumoniae renal abscess for early diagnosis and to identify the clinical risk factors associating with poor prognosis. [ncbi.nlm.nih.gov]
(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]
Etiology
The possible etiology of acute focal bacterial nephritis, its evolution to abscess formation and its distinguishing features are discussed. [ncbi.nlm.nih.gov]
The authors define an unexplained fever as a fever which lasts a minimum of 14 days and whose etiology is not known. [books.google.ro]
Abstract Archives of the RSNA, 2013 Victor Javier Casillas MD, Presenter: Nothing to Disclose 1) To descrbe the clinical presentation, etiology and radiographic imaging modalities to evaluate acute pyelonephritis and renal abscess. 2) To illustrate the [archive.rsna.org]
In addition, various host factors influence the development and severity of renal infection (see Overview/Etiology ). [emedicine.medscape.com]
Etiology of Renal Abscess Gram-negative Bacteria: A renal abscess is most common caused by gram-negative bacteria such as E. coli and Proteus. [urology-textbook.com]
Epidemiology
The CT findings of renal abscesses and neoplasm are discussed as well as a brief discussion on the epidemiology of Salmonella infections. [ncbi.nlm.nih.gov]
"Population-based epidemiologic analysis of acute pyelonephritis" (PDF). Clin Infect Dis. 45 (3): 273–80. doi : 10.1086/519268. PMID 17599303. Archived (PDF) from the original on 2013-12-28. ^ Goodman, TR; McHugh K; Lindsell DR (1998). [en.wikipedia.org]
Epidemiology There are few data available. [patient.info]
Pathophysiology
In a few cases, ascending infection and/or hematogenous spread have been outlined as pathophysiologic mechanisms in published studies. We report on a 7-month-old female infant who was hospitalized with a high fever. [ncbi.nlm.nih.gov]
This book covers pathophysiology of fever, the general approach to the febrile patient, and offers a systematic, in-depth discussion regarding the differential diagnosis of unexplained fever. [books.google.ro]
Prevention
Seite 290 - Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: A meta-analysis. Hepatology 1999; 29: 1655-61 6. [books.google.de]
Prevention On the assumption that most pyelonephritis is caused by ascending infection, its prevention is based on preventing UTI. If children have structural abnormalities of the renal tract they require assessment with a view to correction. [patient.info]
Usually, the flank position is preferred because of ease of establishing a drainage tract and prevention of possible peritoneal exposure to infected material. [emedicine.medscape.com]
"Long-term antibiotics for preventing recurrent urinary tract infection in children". Cochrane Database of Systematic Reviews. 2011 (3): CD001534. doi : 10.1002/14651858.CD001534.pub3. PMID 21412872. [en.wikipedia.org]