Kidney abscess
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Steven C. Campbell, M.D., Ph.D.
Synonyms and keywords: Acute focal bacterial nephritis, acute multifocal bacterial nephritis, emphysematous pyelonephritis, focal pyelonephritis, intrarenal abscess, lobar nephronia, renal corticomedullary abscess
Overview
A kidney abscess is in intrarenal infection. Kidney abscesses are rare.
Pathophysiology
Most perirenal abscesses are caused by urinary tract infections that start in the bladder, spread to the kidney, and then spread to the area around the kidney. Other causes of perirenal abscess include surgery in the urinary tract or reproductive system and bloodstream infection.
The primary pathogens involved in a kidney abscess include the following:
- Enterobacter species
- Escherichia coli
- Klebsiella species
- Proteus mirabilis
- Pseudomonas species
- Streptococcus faecalis
- Staphylococcus aureus
Risk Factors
The biggest risk factor for perirenal abscess is kidney stones that block the flow of urine and provide a place for an infection to grow. Bacteria tend to stick to the stones and antibiotics can't kill the bacteria there.
Stones are found in 20 - 60% of patients with perirenal abscess. Other risk factors for perirenal abscess include:
- Diabetes
- Having an abnormal urinary tract
- Trauma
Natural History, Complications and 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. In rare cases, the infection can spread beyond the kidney area and into the bloodstream, which can be deadly.
If one has kidney stones, the infection may not go away.
Diagnosis
History and 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 leg
- Sweats
Physical Examination
Signs of perirenal abscess include tenderness in the back or abdomen.
Treatment
To treat perirenal abscess, the pus can be drained through a catheter that is placed through the skin or with surgery. Antibiotics should also be given, at first through a vein (IV).
Primary Prevention
The surgical area must be kept as clean as possible after a urologic surgery.