65 Renal Abscess

Clinical Presentation

A 78-year-old diabetic man presents with a spiking fever and flank pain.

Fig. 65.1 Axial contrast-enhanced CT image in a diabetic patient with a history of urinary tract infection shows an ill-defined, hypodense corticomedullary renal abscess.

Radiologic Findings

Axial contrast-enhanced computed tomography (CT) image shows an ill-defined, hypodense left renal lesion with thick walls (Fig. 65.1).

Differential Diagnosis

Lymphoma
Complicated cyst
Renal cell carcinoma
Hydatid cyst
Renal infarct
Metastases
Calyceal diverticulum
Focal xanthogranulomatous pyelonephritis

A renal abscess is an uncommon renal condition. It can be cortical or corticomedullary, depending on the route of infection. When left untreated, a renal abscess can lead to significant mortality and morbidity. With the use of image-guided intervention techniques and antibiotics, mortality and morbidity due to renal abscess are significantly reduced.