Severe pyelonephritis with abscesses

Case contributed by Michael P Hartung
Diagnosis almost certain

Presentation

Flank pain for several weeks.

Patient Data

Age: 55 years
Gender: Male

Abnormal kidneys with bilateral areas of hypoenhancement and forming/coalescing low-attenuation collections (microabscesses), substantially worse on the left with most of the parenchmya involved. No dominant or large/drainable collection. Small amount of nonocclusive clot in the left renal vein. Urinary bladder appears relatively normal. Small ascites.

Case Discussion

Later than the typical presentation of severe pyelonephritis with multiple forming/coalescing microabscesses. There is also a small amount of nonocclusive clot in the left renal vein.

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