Xanthogranulomatous Pyelonephritis with Bilateral Nephrocutaneous Fistulae

Biyani, C. S.; Torella, Francesco; Cornford, Philip; Brough, S.J.B.

doi:10.1159/000283016

Cited by 14 publications

(3 citation statements)

References 3 publications

(3 reference statements)

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“…In previously reported cases, the evaluation was not delayed because the patients had the classical symptoms of pyelonephritis, such as flank pain, and urinary symptoms at the time of the diagnosis. [ 8 ] In the present case, the chief complaint of the patient was a chronic cutaneous fistula. The patient's particular state of quadriplegia rendered no symptoms of XGP, such as flank pain or urinary symptoms.…”

Section: Discussionmentioning

confidence: 64%

Delayed diagnosis of xanthogranulomatous pyelonephritis in a quadriplegic patient with uncontrolled cutaneous fistula

et al. 2018

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Rationale:Xanthogranulomatous pyelonephritis (XGP) is a chronic destructive granulomatous inflammation that is characterized by urinary tract obstruction and invasion of the renal parenchyma. Although rare, XGP can lead to fatal complications, including perinephric inflammation, psoas abscess, and cutaneous fistula.Patient concerns:A quadriplegic patient initially presented to the hospital with a chronic open wound and cutaneous fistula.Diagnoses:Abdominal computed tomography revealed a renal obstructing stone and enlarged right kidney with a perinephric fluid collection that communicated with the cutaneous fistula.Interventions:The patient underwent a right nephrectomy at the department of urology.Outcomes:Two months after surgery, the patient was clinically well with no discharging fistula.Lessons:The XGP accompanied by complications requires an immediate evaluation and early diagnosis. In this case, the diagnosis was delayed because the state of quadriplegia rendered no symptoms of XGP.

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Section: Discussionmentioning

confidence: 64%

Delayed diagnosis of xanthogranulomatous pyelonephritis in a quadriplegic patient with uncontrolled cutaneous fistula

et al. 2018

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“…Patients usually report the presence of flank sinus and discharge of liquid [6] and only one third of the subjects describe loin pain.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Nephrocutaneous Fistula: A Case Report, Update of the Literature and Management Algorithm

Rubilotta¹,

Sarti²,

Artibani³

2014

Urol Int

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Aims: Spontaneous nephrocutaneous fistula (NCF) is a rare and severe condition. The aim of this study was to update the data of the literature about this disease and, reporting and considering also our experience in 1 case of NCF, to make a new clinical algorithm. Methods: This study was done with a review of all the literature and a comparison with our experience. Results: The characteristic sign of spontaneous NCF is a flank sinus discharging material. Physical examination and computed tomography usually lead to the diagnosis. The main predisposing factors are renal stones/staghorn calculi, xanthogranulomatous pyelonephritis and renal tuberculosis. In the vast majority of the cases kidneys are poorly functioning or nonfunctioning. Surgical approach is the common management and usually consists of open nephrectomy. We create a clinical management algorithm obtained by a review of the literature and our experience with spontaneous NCF. Conclusions: Spontaneous NCF represents a very serious renal disease leading to loss of the kidney in the vast majority of cases. We propose a revised and user-friendly clinical diagnostic-therapeutic algorithm for spontaneous NCF based on the worldwide literature.

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“…If left untreated, the resulting perinephric abscess can communicate with other organs or discharge through the skin. Cutaneous fistulae and sinuses, although rare, have been reported in the loin, groin, knee, thigh and axilla [ 1–3]. Nephrectomy and excision or curettage of the sinus tract is the treatment of choice.…”

Section: Commentmentioning

confidence: 99%

Neglected staghorn calculus presenting as a gluteal sinus

Ravi

Awogu

1999

BJU International

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Xanthogranulomatous Pyelonephritis with Bilateral Nephrocutaneous Fistulae

Abstract: This case report describes a patient with bilateral nephrocutaneous fistulae and xanthogranulomatous pyelonephritis. Contralateral involvement of the psoas muscle is a rare occurrence and has not been previously documented.

Cited by 14 publications

References 3 publications

Delayed diagnosis of xanthogranulomatous pyelonephritis in a quadriplegic patient with uncontrolled cutaneous fistula

Delayed diagnosis of xanthogranulomatous pyelonephritis in a quadriplegic patient with uncontrolled cutaneous fistula

Spontaneous Nephrocutaneous Fistula: A Case Report, Update of the Literature and Management Algorithm

Neglected staghorn calculus presenting as a gluteal sinus

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