Recent clinical overview of renal and perirenal abscesses in 56 consecutive cases

Abstract

Background/Aims: The aim of this study was to examine the recent clinical trends and antibiotic susceptibilities of the causative microorganisms in renal and perirenal abscesses, and to elucidate the factors associated with treatment strategies.Methods: We retrospectively analyzed 56 patients who were diagnosed with renal and perirenal abscesses at our hospital from January 2000 to September 2007.Results: The mean age of the patients was 53.5 years, and a female predominance of patients (75%) was observed. Diabetes mellitus (44.6%) was the most common predisposing condition. The mean duration of symptoms before diagnosis was 11.6 days, and fever (75%) was the most common symptom. Escherichia coli (44%) and Klebsiella pneumoniae (28%) were common pathogens, and the rates of susceptibility of E. coli isolates to ampicillin, cephalothin, cefotaxime, trimethoprim-sulfamethoxazole, ciprofloxacin, gentamicin, and imipenem were 18.2%, 27.3%, 72.7%, 72.7%, 63.6%, 63.6%, and 100%, respectively. Abscesses were classified according to the location as follows: renal abscess (n=31, 55.4%) and perirenal abscess±renal abscess (n=25, 44.6%). In the renal abscess group, the infection rate of gram-negative organisms was higher than in the perirenal abscess group. Patients were also divided according to the treatment modality: antibiotics only (n=20, 35.7%) and percutaneous intervention or surgery (n=36, 64.3%). Patients who had a perirenal abscess or a large renal abscess required more invasive treatment.Conclusions: This study revealed somewhat different results from those of previous studies. Clinical and microbial differences were observed between the renal and perirenal abscess groups. Abscess location and the size of the renal abscess were the factors associated with treatment strategies.

An unexpected case of bilateral kidneys studded with multiple abscesses, in a nondiabetic healthy woman-A case report

“…5 Renal abscess was also classifi ed into three groups according to the size of abscess as follows: < 3 cm, 3-5 cm and > 5 cm. 1 In our case, one of the abscess in left kidney was of > 3 cm in size. Hence USG guided percutaneous drainage was performed.…”

“…Ascending infections account for more than 75% of all renal abscesses and this usually involve medulla by gram negative organisms. 1 In our case, there is no known predisposing condition. Bilateral renal abscesses in a young woman with type I diabetes is reported 2 and is a known fact.…”

“…1 It is known to develop from ascending infections of the lower urinary tract or by hematogenous seeding from primary infected sites. Ascending infections account for more than 75% of all renal abscesses and this usually involve medulla by gram negative organisms.…”

“…The common predisposing conditions for renal abscesses described are systemic diseases such as diabetes mellitus, liver cirrhosis, underlying urinary obstructions, renal stones, renal or urologic disorders. 1 The less common causes include intravenous drug abuse, chronic debilitating disease and immunocompromised status.…”

Renal and perinephric abscesses in West China Hospital: 10-year retrospective-descriptive study

“…of RAs and PNAs [3,7,10,11] . Anatomical malformation of the urinary tract, vesicoureteral reflux and obstructive tumors in renal polycystic disease are other previously described risk factors [1,18] .…”