Retroperitoneal abscess with subcutaneous extension: case report of a rare complication of percutaneous renal biopsy

Abstract

BackgroundInfective complications following percutaneous renal biopsy are rare, even among immunocompromised. However it is important to be vigilant about such complications, to detect them early and prevent morbidity and mortality. We report a case of retroperitoneal abscess with extension to subcutaneous plane after a renal biopsy.Case presentationA 42-year-old female with long standing cutaneous lupus underwent renal biopsy for evaluation of nephrotic range proteinuria. She was on high dose prednisolone complicated with steroid induced hyperglycaemia. Eight weeks after the biopsy she presented with left flank pain, malaise and fever. There was a tender subcutaneous induration over the biopsy site. Contrast CT abdomen showed a retroperitoneal abscess with subcutaneous extension along the path of the biopsy needle. This was successfully treated with surgical drainage and broad-spectrum antibiotics.ConclusionsInfections and abscess formation are rare but serious complications of renal biopsy. Immunocompromised state is a potential risk factor. Possible mechanisms and measures for prevention and early detection of this rare complication are discussed.Electronic supplementary materialThe online version of this article (10.1186/s12882-018-1112-1) contains supplementary material, which is available to authorized users.

Disparate effects of methicillin-resistant Staphylococcus aureus infection on renal function in IgA-dominant infection-associated glomerulonephritis and menstrual toxic shock syndrome: a case report and literature review

“…The safety of this procedure was recently questioned in immunocompromised patients or patients with unbridled infection because of the potential risk of sepsis 41 or perinephric abscess. 42 We believe that renal biopsy is preferable for cases with uncertain diagnosis or prognosis and should be handled with discretion in cases with bacteremia or septicemia, such as mTSS, in which the etiology of AKI is less ambiguous.…”

Diagnosis and Treatment of Retroperitoneal Infection

“…Surgery and trauma of the retroperitoneal and intraperitoneal organs are more likely to lead to retroperitoneal infection. In recent years, retroperitoneal infections caused by the abdominal war wound and trauma, surgical complications, and lumbar puncture have been reported, increasing the incidence of iatrogenic injury or trauma annually [26][27][28]. Medical procedure-related retroperitoneal infections are mainly caused by surgeries of the duodenal fistula, common bile duct injury, severe pancreatitis, appendix, sigmoid colon, and the rectum.…”