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Title: Renal and perirenal abscesses

Abstract

Our knowledge of the spectrum of renal abscesses has increased as a result of more sensitive radiologic techniques. The classification of intrarenal abscess now includes acute focal bacterial nephritis and acute multifocal bacterial nephritis, as well as the previously recognized renal cortical abscess, renal corticomedullary abscess, and xanthogranulomatous pyelonephritis. In general, the clinical presentation of these entities does not differentiate them; various radiographic studies can distinguish them, however. The intrarenal abscess is usually treated successfully with antibiotic therapy alone. Antistaphylococcal therapy is indicated for the renal cortical abscess, whereas therapy directed against the common gram-negative uropathogens is indicated for most of the other entities. The perinephric abscess is often an elusive diagnosis, has a more serious prognosis, and is more difficult to treat. Drainage of the abscess and sometimes partial or complete nephrectomy are required for resolution. 73 references.

Authors:
;
Publication Date:
Research Org.:
Yale Univ. School of Medicine, New Haven, CT (USA)
OSTI Identifier:
6289393
Resource Type:
Journal Article
Resource Relation:
Journal Name: Infect. Dis. Clin. North Am.; (United States); Journal Volume: 1:4
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; KIDNEYS; ABSCESSES; NEPHRITIS; RADIOBIOLOGY; DIAGNOSIS; NEPHRECTOMY; RADIOTHERAPY; REVIEWS; BIOLOGY; BODY; DISEASES; DOCUMENT TYPES; MEDICINE; NUCLEAR MEDICINE; ORGANS; PATHOLOGICAL CHANGES; RADIOLOGY; SURGERY; THERAPY; UROGENITAL SYSTEM DISEASES; 550602* - Medicine- External Radiation in Diagnostics- (1980-); 550601 - Medicine- Unsealed Radionuclides in Diagnostics; 550603 - Medicine- External Radiation in Therapy- (1980-)

Citation Formats

Patterson, J.E., and Andriole, V.T.. Renal and perirenal abscesses. United States: N. p., 1987. Web.
Patterson, J.E., & Andriole, V.T.. Renal and perirenal abscesses. United States.
Patterson, J.E., and Andriole, V.T.. 1987. "Renal and perirenal abscesses". United States. doi:.
@article{osti_6289393,
title = {Renal and perirenal abscesses},
author = {Patterson, J.E. and Andriole, V.T.},
abstractNote = {Our knowledge of the spectrum of renal abscesses has increased as a result of more sensitive radiologic techniques. The classification of intrarenal abscess now includes acute focal bacterial nephritis and acute multifocal bacterial nephritis, as well as the previously recognized renal cortical abscess, renal corticomedullary abscess, and xanthogranulomatous pyelonephritis. In general, the clinical presentation of these entities does not differentiate them; various radiographic studies can distinguish them, however. The intrarenal abscess is usually treated successfully with antibiotic therapy alone. Antistaphylococcal therapy is indicated for the renal cortical abscess, whereas therapy directed against the common gram-negative uropathogens is indicated for most of the other entities. The perinephric abscess is often an elusive diagnosis, has a more serious prognosis, and is more difficult to treat. Drainage of the abscess and sometimes partial or complete nephrectomy are required for resolution. 73 references.},
doi = {},
journal = {Infect. Dis. Clin. North Am.; (United States)},
number = ,
volume = 1:4,
place = {United States},
year = 1987,
month =
}
  • Twelve patients with urosepsis and severe renal or perirenal infections were evaluated with both computed tomography (CT) and sonograhy. Six patients had nine proven renal or perirenal abscesses larger than 2 cm in diameter. One patient had multiple microabscesses smaller than 1 cm. Five patients had CT or sonographic evidence of focal or multifocal bacterial nephritis. Computed tomography correctly diagnosed all renal (six) and perirenal (three) abscesses. Sonography was falsely negative in a patient with multiple microabscesses and in another patient with a gas-forming perinephric abscess. In one patient with four bilateral renal abscesses, sonography correctly diagnosed only one ofmore » the abscesses. In the five patients with focal or multifocal bacterial nephritis, CT demonstrated poorly defined, poorly enhancing lesions in all cases. Sonography was normal in three of these patients. Although this report is based on a limited experience, computed tomography seems to be the more sensitive method of evaluating severe renal and perirenal infections.« less
  • A uriniferous perirenal pseudocyst is a mass formed by collection of extravasated urine within the perirenal fascia. It may result from closed renal injury, surgical operation, or arise spontaneously in the presence of obstruction. To our knowledge, only two cases have been reported about radionuclide imaging in this condition. We present a case in whom a unique scintillation camera image of the kidney was created with /sup 99m/Tc-dimercaptosuccinic acid (DMSA).
  • The case of a newborn infant with a high-grade ureterovesical junction obstruction--a primary obstructive megaureter--who presented with a perirenal pseudocyst (urinoma) is discussed. Radionuclide studies allowed recognition of this collection and led to the discovery of the ureteral obstruction. The rarity of urinomas in neonates and the scintigraphic appearance of urinomas are emphasized.
  • Two etiologically different models of experimental acute renal failure were induced in rats by administration of either glycerol or uranyl nitrate. Both compounds caused a substantial decrease in the glomerular filtration rate (GFR) and the net tubular secretion of tetraethylammonium bromide (TEAB) and para-aminohippuric acid (PAH). The degree of renal impairment induced by uranyl nitrate and glycerol appeared to be dose related. Deprivation of drinking water 24 hr before the administration of glycerol potentiated the renal damage. In uranyl nitrate-induced renal failure, the decline of the net tubular secretion for TEAB and PAH was not proportional to the decrease inmore » GFR; the secretion process deteriorated faster than the GFR. For example, when 0.5 mg/kg uranyl nitrate was administered, GFR fell to approximately 65% of normal, whereas the net tubular secretion was decreased to 30% of normal. These results suggest that the tubular transport was preferentially affected by uranyl nitrate. In contrast, in glycerol-induced renal failure, the decline of TEAB secretion fell in a parallel fashion with the GFR, suggesting that the glomeruli and the proximal tubules were equally damaged by glycerol. However, in this latter model, the decline of PAH secretion did not parallel the decrease in GFR, contradicting the proposal that glycerol affects equally the glomeruli and the proximal tubules. This discrepancy may be due to the selective competitive inhibition of PAH secretion by the accumulation of naturally occurring organic acids.« less