1. Renal abscess

2. Introduction Abscess in the renal parenchyma
Also known as the carbuncle of the kidney
Etiology:
Staphylococcus aureus: released from distance sources
Injury to the kidney
E. coli

3. Clinical features Symptoms: fever, chills, loin pain Signs:
extreme tenderness over the affected kidney

4. Investigations Blood: elevated WBC Urine:
usually negative in the early stages
Pus cells & bacteria if the abscess ruptures into the renal pelvis
Straight X- ray: enlarged kidney
IVU: space occupying lesion obliterating or compressing a group of calyces &/ or a part of the pelvis of the ureter

5. 36-year-old man with left renal abscess
36-year-old man with left renal abscess. Longitudinal gray-scale sonogram of left kidney shows well-defined hypoechoic mass (arrow) near mid region of kidney.

6. Nonenhanced CT scan through the mid pole of the right kidney demonstrates right renal enlargement and an area of decreased attenuation

7. A, Enhanced CT scan shows an irregular septated low-density mass (M) extensively involving the left kidney.
Note thickening of perinephric fascia) and extensive compression of the renal collecting system. Findings are typical of renal abscess.
B, Ultrasound longitudinal scan demonstrates a septated hypoechoic mass (M) occupying much of the renal parenchymal volume

9. Treatment
Antibiotics
Surgical drainage
Nephrectomy

10. Perinephric abscess

11. Introduction
Abscess between the renal capsule & the perirenal fascia of Gerota

12. Etiology Primary: hematogenous Secondary:
Infection travels from neighboring organs
Usually follows renal abscess
Infection of a perirenal hematoma

14. Clinical features
Symptoms: typical history of prolonged urinary infection, fever, pain in the flank
Signs: fever, marked tenderness over the kidney, scoliosis of the spine

15. Investigations Blood: leukocytosis, anemia Urine: Straight X- ray:
Pyuria & bacteriuria
Straight X- ray:
Obliteration of the renal & psoas shadow
Scoliosis of the spine
IVU: Mathe’s sign
Isotope scanning

16. Treatment
Antibiotics
Surgical drainage