Abstract
Materials and Methods
We reviewed the medical records of 33 patients with renal, perinephric, and mixed abscesses treated at our hospital between January 1998 and March 2008. The medical records, including predisposing conditions, clinical manifestations, physical examination, laboratory and radiologic findings, duration of hospitalization, types of uropathogens, time to clinical improvement, time to laboratory improvement, treatment, and clinical outcomes, were retrospectively analyzed.
Results
Renal, perinephric and mixed abscesses occurred in 22 (66.7%), 4 (12.1%), and 7 (21.2%) patients. The most common predisposing conditions were diabetes mellitus (39.4%) and liver disease (27.3%). Flank pain (57.6%) and fever (54.5%) were the most common symptoms. Urine and blood cultures were positive in 23.3 and 19.2% of patients, respectively. The most common isolated uropathogen in the urine, blood, and purulent cultures was E. coli. The time to clinical and laboratory improvement was not significantly different between the patients with renal, perinephric, and mixed abscesses. Patients with renal, perinephric, and mixed abscesses received antibiotic therapy only in 59.1, 50.0, and 42.9% of cases, respectively. Similarly, patients with renal, perinephric, and mixed abscesses underwent percutaneous or surgical drainage in 22.7, 50.0, and 14.3% of cases, respectively. Patients required a nephrectomy in 18.2 and 42.9% of renal and mixed abscess cases, respectively. Most patients were cured (54.5%) or improved (42.4%) at the time of discharge from the hospital.
References
1. Jin WY, Lee JH, Lee YJ, Jang IC, Jo DH. A clinical review of 16 cases of renal of perirenal abscess. Korean J Urol. 1988; 29:761–5.
2. Kim JH, Park YI. Conservative management of the renal and perirenal abscesses. Korean J Urol. 2001; 42:185–8.
3. Hwang YJ, Woo YN. Percutaneous management of the renal and perirenal abscess. Korean J Urol. 1994; 35:261–4.
4. Park SG, Chai SE. Clinical observation on renal and perinephric abscess. Korean J Urol. 1987; 28:269–73.
5. Jung UY, Kim DH. A clinical survey on perinephric abscess. Korean J Urol. 1985; 26:7–12.
6. Kim WS, Lee MS. A clinical observation on perinephric abscess (II). Korean J Urol. 1983; 24:794–800.
7. Hong SJ, Kim HJ. A clinical observation on perinephric abscess. Korean J Urol. 1979; 20:373–7.
8. Hoverman IV, Gentry LO, Jones DW, Guerriero WG. Intrarenal abscess. Report of 14 cases. Arch Intern Med. 1980; 140:914–6.
9. Meng MV, Mario LA, McAninch JW. Current treatment and outcomes of perinephric abscesses. J Urol. 2002; 168:1337–40.
10. Edelstein H, McCabe RE. Perinephric abscess. Modern diagnosis and treatment in 47 cases. Medicine. 1988; 67:118–31.
11. Coelho RF, Schneider-Monteiro ED, Mesquita JL, Mazzucchi E, Marmo Lucon A, Srougi M. Renal and perinephric abscesses: analysis of 65 consecutive cases. World J Surg. 2007; 31:431–6.
13. Truesdale BH, Rous SN, Nelson RP. Perinephric abscess: a review of 26 cases. J Urol. 1977; 118:910–1.
14. Shu T, Green JM, Orihuela E. Renal and perirenal abscesses in patients with otherwise anatomically normal urinary tracts. J Urol. 2004; 172:148–50.
15. Capitan MC, Tejido SA, Piedra LJ, Martinez SV, Cruceyra BG, Rosino SA, et al. Retroperitoneal abscesses-analysis of a series of 66 cases. Scand J Urol Nephrol. 2003; 37:139–44.
16. Park WH, Heo YC, Lee JH, Lee SL, Choi YC, Shim HY. Acute renal infection: recent experience and clinical value of renal ultrasonography. Korean J Urol. 1998; 39:524–9.
17. Hong JM, Kim TK. Acute bacterial renal infection: role of computed tomography. Korean J Urol. 1995; 36:181–8.