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Cat scratch disease (CSD) is a self-limiting infectious disease that develops after a cat bite or scratch, caused by the Gram-negative bacillus Bartonella henselae. The disease is generally characterized by fever and regional granulomatous lymphadenopathy, but in 5-10% of cases it can occur as a systemic disease and lead to various diseases. A 31 year old healthy woman applied to the internal medicine clinic with right side pain. He was referred to the urology clinic after the urinary system USG revealed a 4x3cm cystic mass in the right kidney. There was no finding in the patient"s history other than a cat bite 3 months ago. Radiological evaluations showed RCC suspicion in the right kidney with the classification of Bosniak type 3 cyst. Upon being reported as a medical condition, the patient underwent laparoscopic partial nephrectomy. Multiple abscesses in the liver and spleen, and microabscesses in both kidneys, accompanied by systemic inflammatory symptoms, have previously been reported in systemic CSD. However, as far as we know, this is the first case of Bartonella henselae in the literature showing isolated single kidney involvement of this size without showing systemic inflammatory symptoms.

Introduction: Klebsiella pneumoniae can cause a wide range of infections. Hypervirulent K. pneumoniae (hvKp), particularly associated with the K1 and K2 capsular types, is an increasingly significant microorganism with the potential to cause invasive infections, including renal abscesses. Despite the rising prevalence of hvKp infections, information on renal abscesses caused by K. pneumoniae is limited, and the clinical significance of hvKp associated with specific virulence genes remains elusive. Methods: This study performed at a 1200-bed tertiary hospital sought to identify the clinical and microbiological characteristics of renal abscesses caused by K. pneumoniae, focusing on various virulence genes, including capsular serotypes and multilocus sequence typing (MLST). Results: Over an 8-year period, 64 patients with suspected renal abscesses were reviewed. Ten patients diagnosed with K. pneumoniae-related renal abscesses were ultimately enrolled in the study. Among the isolates from the 10 patients, capsular serotype K2 was predominant (40.0%), followed by K1 (30.0%). The most common sequence type by MLST was 23 (40.0%). In particular, six patients (60.0%) harbored specific genes indicative of hvKp: iucA, peg-344, rmpA, and rmpA2. Conclusions: Our findings highlight the importance of hvKp as a pathogen in renal abscesses. Although the nature of hvKp is relatively unknown, it is widely recognized as a highly virulent pathogen that can infect relatively healthy individuals of various ages and simultaneously cause infections at multiple anatomical sites. Therefore, when treating patients with K. pneumoniae-related renal abscesses, caution is necessary when considering the characteristics of hvKp, such as potential bacteremia, multi-organ abscess formation, and metastatic spread. [ABSTRACT FROM AUTHOR]

A 70-year-old male patient presented with complaints of fever and burning micturition for the past five days associated with left loin pain and vomiting. There was no history of haematuria. The patient was a known case of diabetes and hypertension and had been on irregular treatment for the past five years. Upon examination, the patient was hemodynamically stable, and there was tenderness in the left flank region.

Renal abscesses are rare in pediatric populations. We aimed to highlight the differences in the computed tomography (CT) imaging characteristics of renal abscesses in patients with and without vesicoureteral reflux (VUR). Thirteen children with renal abscesses were included and categorized into those with and without VUR. Blood and urine culture results were recorded as positive or negative. Imaging characteristics were recorded: with/without subcapsular fluid collection, with/without upper/lower pole involvement, and with single/multiple lesions in kidneys. Fisher's exact test was used for intergroup comparisons of the rate of positive pathogens and imaging characteristics. Nine patients had VUR (45.9%). Blood and urine culture were positive in two (15.4%) and seven cases (53.8%), respectively. There was no significant difference in the rate of pathogen-positive blood and urine cultures (blood culture positive/negative status with VUR vs. that without VUR = 2/7 vs. 0/4, p > 0.999, urine culture positive/negative status with VUR vs. that without VUR = 4/5 vs. 3/1, p = 0.559). The two groups differed significantly regarding subcapsular fluid collection presence (with/without subcapsular fluid collection with VUR vs. that without VUR = 9/0 vs 1/3, p = 0.014). There was no significant difference in upper/lower pole involvement (with/without involving upper/lower pole with VUR vs. that without VUR = 8/1 vs 2/2, p = 0.203). Patients with VUR were non-significantly more likely to have multiple lesions compared to those without VUR. VUR was associated with subcapsular fluid collection and possibly with multiple lesions, indicating the need for prompt detection of and specific treatment for VUR in cases with these findings. [ABSTRACT FROM AUTHOR]

Severe consequences can ensue from the rupture and hemorrhage of a renal artery pseudoaneurysm, necessitating immediate intervention upon detection. To date, no reports exist on the development of renal artery pseudoaneurysms as a result of renal abscesses. This document introduces the first reported case of this occurrence.

Background: Acute lobar nephronia (ALN) is an underdiagnosed urological condition which has scarce publications available. It is described as an acute inflammatory and bacterial infection of the kidney without liquefaction, and in fact likely represents a mid-point between acute pyelonephritis and renal abscess. Patients usually present with fevers, septic shock, and occasionally abdominal and flank pain. To date there is no consensus on its optimal management. Objective: The aim of this study was to describe the presentation, evaluation, multidisciplinary involvement and management, and follow-up of ALN. Method: An observational study was performed utilising four patients from our single centre urology department. Data collected included basic demographics and diagnosis and management. All four patients are presented below. Observations and comparisons were made between all patients to aid in understanding the commonality between their presentations and managements. Conclusion: ALN is an underdiagnosed condition. Its diagnosis and management is difficult and requires a multidisciplinary approach. Many patients require prolonged inpatient management and close follow-up. An underlying renal mass is always an important differential diagnosis to be considered. Level of evidence: Not applicable for this multicentre audit. [ABSTRACT FROM AUTHOR]

Renal vein thrombosis is not a common manifestation in the context of acute pyelonephritis. We report the case of a 29-year-old female diabetic patient that was admitted to our department for an episode of complicated acute pyelonephritis. Initial imaging showed a left lower polar abscess of 27 mm and urine cultures grew community acquired K. Pneumoniae. Two days after the patient was discharged, she was readmitted with worsening symptoms. Repeat imaging showed stability in the size of the abscess and revealed a left lower segmental vein thrombosis. The patient responded favorably to antibiotics and heparin-warfarin therapy.

Aims: This study aims to evaluate the (a) accuracy of conventional and diffusion-weighted-imaging (DWI) sequences in the diagnosis of acute pyelonephritis and (b) minimum apparent diffusion coefficient (ADC) values for the diagnosis of acute pyelonephritis and the differentiation of renal abscesses from acute pyelonephritis. Materials and methods: Ultrasound, conventional MRI sequences, and DWI were used to evaluate the kidneys in 68 patients suspected to have acute pyelonephritis. Multiple similar regions of interest (ROIs) were placed over the renal parenchyma with visually identifiable diffusion restriction, over the non-diffusion-restricted renal parenchyma of affected kidneys and over the normal kidneys. Corresponding minimum ADCs were noted for analysis. Pyelonephritis was confirmed based on clinical criteria, laboratory findings, and by resolution/development of known complications of pyelonephritis. Result: DWI showed the highest sensitivity(100%), while DWI read with T2-weighted imaging (both being positive) showed the highest specificity(100%) for the diagnosis of acute pyelonephritis in our population with a high baseline creatinine. The minimum-ADC of the nephritic diffusion-restricted area in patients with confirmed pyelonephritis was significantly lower than the minimum-ADC in patients without pyelonephritis [(0.934 ± 0.220, mean ± SD) vs (1.804 ± 0.404) × 10−3 s/mm2] (p < 0.001). ROC cut-off of minimum-ADC for the diagnosis of acute pyelonephritis was 1.202 × 10−3 s/mm2 (area under curve 0.978). The minimum-ADC of the abscesses were significantly lower when compared to the minimum-ADC of the nephritic diffusion-restricted portion of the same kidney [(0.633 ± 0.248) vs (0.850 ± 0.191) × 10−3 s/mm2] (p < 0.001). Conclusion: DWI is an excellent stand-alone imaging tool that can be combined with conventional sequences for the diagnosis of APN even in patients with high serum-creatinine or other contraindications to intravenous contrast. Further, ADC values can be used to differentiate between renal abscesses and uncomplicated pyelonephritis. [ABSTRACT FROM AUTHOR]

Acute pyelonephritis (APN) is a bacterial infection causing inflammation of the kidneys. Diagnosis is usually based on clinical and laboratory findings. Imaging is required if a complication is suspected in acute pyelonephritis to assess the nature and extent of the lesions and to detect underlying causes. CT represents the current imaging modality of choice in clinical practice. CEUS is an alternative that has been proven to be equally accurate in the detection of acute pyelonephritis renal lesions. CEUS allows us to distinguish small simple nephritic involvement from abscess complications and to follow their evolution over time during antibiotic therapy. The absence of ionizing radiation and the lack of nephrotoxicity make CEUS an ideal tool in the study of pyelonephritis. [ABSTRACT FROM AUTHOR]

Nephrocutaneous fistula (NCF) is a very serious rare renal disorder that had not been recorded in cats. This case report describes  for the first time  the features and treatment of a nephrocutaneous fistula in a 3-year-old female intact Persian cat. The cat was referred with a history of lethargy, ano-rexia, vomiting and recurrent abscess discharging purulent material at the right flank region. More-over, the cat had a history of cystitis, urethritis and urethral obstruction since 12 months. Physical, laboratory, radiographic and ultrasonographic examinations were performed. The cat was treated with simple nephrectomy and excision of the fistulous tract. The animal showed dehydration, fever, painful abdominal palpation, right nephromegaly, anaemia, neutrophilic leukocytosis and moderate azotae-mia. Abdominal radiographs revealed a large radiodense mass at the mid abdomen displacing the intestine caudally. Ultrasonography revealed a renal abscess with marked enlargement of the right kidney, hyperechoic purulent content and loss of parenchymal details of the right kidney. Complete recovery of the cat without any complications was seen after surgical treatment. In conclusion, nephrocutaneous fistula should be listed as one of renal diseases in cats. Nephrectomy as well as excision of the fistulous tract appear to be successful in the treatment of this disorder in cats.

Abstract Background Iliopsoas abscess is a relatively rare but serious infectious disease. Infectious disease is one of the major causes of death among patients receiving hemodialysis for end-stage renal disease (ESRD). Case presentation We experienced three cases of iliopsoas abscess in patients receiving hemodialysis. The infection route was distinct in each case. A 79-year-old woman with ESRD due to autosomal dominant polycystic kidney disease exhibited bilateral iliopsoas abscesses caused by bacterial contamination during a lumbar epidural block procedure. A 60-year-old woman with ESRD due to diabetic nephropathy was diagnosed as having an iliopsoas abscess, caused by the direct invasion of bacteria from a renal abscess. A 78-year-old woman who started hemodialysis because of nephrosclerosis developed an iliopsoas abscess caused by the hematogenous spread of bacteria from emphysematous cystitis. All three cases were treated with antibiotics and/or percutaneous drainage. A survey of published reports suggested that iliopsoas abscess can be caused by infection through a variety of routes in hemodialysis patients. Conclusion Because hemodialysis patients are at a high risk of infection because of their immunocompromised state, physicians should pay close attention to infection prevention. If iliopsoas abscess is suspected, examinations such as computed tomography, magnetic resonance imaging, and blood culture sampling should be conducted promptly, followed by appropriate treatment with antibiotics and/or drainage.

Objective: To evaluate the association between the incidence of renal scarring on technetium-99 m dimercaptosuccinic acid (DMSA) renal scintigraphy and the severity of renal parenchymal infections, such as acute pyelonephritis (APN), acute focal bacterial nephritis (AFBN), and renal abscess, based on computed tomography (CT) diagnosis. Methods: Sixty-one children with renal parenchymal infections were included and classified into two groups: those with (renal scarring group) and without renal scarring (non-renal scarring group) on chronic-phase DMSA renal scintigraphy. The severity of renal parenchymal infection was classified into three grades using CT: APN, AFBN, and renal abscess as grades 1, 2, and 3, respectively. The severity of renal parenchymal infection, vesicoureteral reflux (VUR) grade, and intrarenal reflux occurrence during voiding cystourethrography (VCUG) were evaluated between the renal and non-renal scarring groups. Fisher's exact test and Mann–Whitney U test were used for statistical analysis. Results: Renal scars were detected in 28 (45.9%) of the 61 patients. We found that 2/9 (22.2%), 18/41 (43.9%), and 8/11 (72.7%) patients with APN (grade 1), AFBN (grade 2), and renal abscess (grade 3) had renal scarring, respectively. There was a significant difference in the grade of severity of renal parenchymal infection between the renal (median = 2 [interquartile range, 2–3]) and non-renal (median = 2 [interquartile range, 2–2]) scarring groups (p = 0.023). There was a significant difference in the grade of VUR between the renal (median = 3 [interquartile range, 0–4]) and non-renal (median = 0 [interquartile range, 0–2]) scarring groups (p = 0.004). No significant difference in intrarenal reflux occurrence was observed between the renal (present/absent: 3/25) and non-renal (present/absent: 0/29) scarring groups (p = 0.112). Conclusion: Our results showed that pediatric patients with renal scarring on chronic-phase DMSA renal scintigraphy tended to have a more severe renal infection. [ABSTRACT FROM AUTHOR]

(1) Introduction and Aims: Little is known about the relationship between renal pathology and gallbladder pathology, although the two organs (the gallbladder and the right kidney) are in close proximity to one another. If a renal abscess disseminates, the gallbladder would be one of the secondary organs involved. As the bile provides a favorable environment for the development of pathogenic germs, it allows for the development of acute cholecystitis, even if calculi are absent, thus resulting in the development of acute acalculous cholecystitis. The aim of our study was to analyze the association between acute acalculous cholecystitis (AAC) and renal abscesses. (2) Methods: A department-wide retrospective cohort observational study including 67 patients with renal abscesses, with a mean age of 34.5+/−16.21 years and with five males and 62 females, was conducted. All of the patients were examined by an abdominal ultrasound. The lab tests included CBC with differential liver enzymes and serum bilirubin (in order to assess alterations in the liver function which can be associated with AAC) and serum creatinine (in order to assess the renal function). Blood culture and urine culture tests were also performed. (3) Results: Of the 67 patients with renal abscesses, eight (11.94%) were associated with acute cholecystitis: four cases (5.97%) of acalculous cholecystitis and four cases (5.97%) of calculous cholecystitis, two of which presented biliary sludge (acute micro-calculous cholecystitis). All four cases of acute acalculous cholecystitis presented with sepsis, and there was one case of septic shock at onset. We did not observe an impairment in renal function in the patients presenting with acute acalculous cholecystitis, and hepatic impairment was inconstant and moderate. All of the cases had a favorable outcome after a prompt initiation of intensive antibiotic therapy; both the renal abscess and the acute acalculous cholecystitis receded without further complications. (4) Conclusions: The association of acute acalculous cholecystitis with renal abscesses could be related to the possibility of germ dissemination from the infectious focus. In the case of a renal abscess, careful clinical, lab, and imaging exams of the gallbladder are recommended in order to ensure early therapeutic intervention in the event of an association with acute acalculous cholecystitis. [ABSTRACT FROM AUTHOR]

Sarcomatoid urothelial carcinoma (SUC), a rare tumor of the urinary tract epithelium, exhibits a high degree of malignancy and therefore a poor prognosis. Due to the absence of specific clinical presentations and imaging findings, SUC of the renal pelvis masquerades as a renal abscess is frequently under-recognized or misdiagnosed as benign inflammatory disease, resulting in delayed or erroneous treatment. Here, we report a patient with SUC of the renal pelvis who presented with a renal abscess. Repeated anti-inflammatory treatment was ineffective. Unexpectedly, cancerous cells were detected in subsequent exfoliative cytology of nephrostomy drainage fluid. In accordance with this, radical surgery and postoperative chemotherapy were conducted. Fortunately, neither recurrence nor metastasis occurred during a one-year follow-up. [ABSTRACT FROM AUTHOR]

Copyright of Revista Sociedad Colombiana de Oftalmología is the property of Sociedad Colombiana de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article focuses on the imaging findings of a spontaneous subcapsular hematoma as a complication of acute pyelonephritis. Topics include the patient's clinical presentation and diagnostic imaging, differential diagnosis considering renal abscess rupture and ureteric calculus, and the treatment approach involving percutaneous drainage and ureteroscopic stone retrieval.

Background: There is limited literature on renal abscesses in children and therefore no consensus on management. The objectives of this study were to describe renal abscesses in a contemporary paediatric Australian population and present a 20 year review of the literature. Methods: An 11 year retrospective comparative study was conducted of paediatric patients with renal abscesses. A literature review of all eight original articles on paediatric renal abscesses from January 2001 to December 2021 was performed. Results: Fourteen children with a mean age of 11 years were diagnosed with a renal abscess on ultrasound and/or computed tomography. The most common presenting symptoms were fever (n = 13, 93%) and flank or abdominal pain (n = 12, 86%). The most common causative organisms were Staphylococcus aureus (n = 7, 50%) and Escherichia coli (n = 4, 29%). All renal abscesses less than 3 cm were managed with antibiotics alone. Five out of nine abscesses 3–5 cm were managed with percutaenous drainage (56%). Two multi‐loculated abscesses greater than 5 cm required open drainage in theatre (100%). Conclusions: The most common causative organism in the North Queensland population was S. aureus, with a higher incidence of MRSA. This should be taken into consideration when prescribing empirical antibiotics. Most renal abscesses in children that are less than 3 cm in size can be managed with antibiotic therapy only. The evidence for management of larger abscesses is less clear, but where clinically appropriate conservative management with antibiotic therapy should be considered in the first instance, with percutaneous drainage in cases of antibiotic failure. [ABSTRACT FROM AUTHOR]

Nephrocutaneous fistula (NCF) is a very serious rare renal disorder that had not been recorded in cats. This case report describes - for the first time - the features and treatment of a nephrocutaneous fistula in a 3-year-old female intact Persian cat. The cat was referred with a history of lethargy, anorexia, vomiting and recurrent abscess discharging purulent material at the right flank region. Moreover, the cat had a history of cystitis, urethritis and urethral obstruction since 12 months. Physical, laboratory, radiographic and ultrasonographic examinations were performed. The cat was treated with simple nephrectomy and excision of the fistulous tract. The animal showed dehydration, fever, painful abdominal palpation, right nephromegaly, anaemia, neutrophilic leukocytosis and moderate azotaemia. Abdominal radiographs revealed a large radiodense mass at the mid abdomen displacing the intestine caudally. Ultrasonography revealed a renal abscess with marked enlargement of the right kidney, hyperechoic purulent content and loss of parenchymal details of the right kidney. Complete recovery of the cat without any complications was seen after surgical treatment. In conclusion, nephrocutaneous fistula should be listed as one of renal diseases in cats. Nephrectomy as well as excision of the fistulous tract appear to be successful in the treatment of this disorder in cats. [ABSTRACT FROM AUTHOR]

Yanfei Lu,1,2,&ast; Wenying Xia,1,2,&ast; Fang Ni,1,2 Yuqiao Xu1,2 1Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People’s Republic of China; 2Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yuqiao Xu, Department of Laboratory Medicine, Jiangsu Province Hospital, Guangzhou Street No. 300, Nanjing, 210029, People’s Republic of China, Tel + 8625-6830-6287, Fax + 8625-8372-4440, Email joe8165@163.comAbstract: Peptoniphilus asaccharolyticus is a Gram-positive anaerobic coccus, which forms part of the normal flora and the human commensals of the skin, genitourinary system, and gut. It can cause opportunistic infections in immunocompromised patients and is frequently isolated as part of polymicrobial spectra. Severe monomicrobial infections caused by the genus rarely occur. In this study, we report on septic shock, renal abscess, and bacteremia due to P. asaccharolyticus in a woman with nephrosis and diabetes mellitus. To the best of our knowledge, this report is the first to describe P. asaccharolyticus isolated from both renal abscess and blood cultures purely. The underlying diseases of the host and the removal of the double J tube were significant predisposing factors in this infection.Keywords: Peptoniphilus asaccharolyticus, septic shock, renal abscess, bacteremia, immunocompromised

Abstract Background Renal abscesses are relatively uncommon in children, and usually due to Gram-negative rods or Staphylococcus aureus, whereas abscesses caused by Salmonella are very rare. Case presentation We present the case of a previously healthy 10-year-old boy who had a renal abscess due to Salmonella bareilly. He responded well to treatment with antibiotics, and computed tomography (CT)-guided drainage of the abscess. His blood, urine and abscess aspirate cultures were sterile, but a broad-range 16S rDNA polymerase chain reaction (PCR) assay of the aspirate followed by analysis of four Salmonella genes (fliC, fliD, sopE2, and spaO) identified S. bareilly as the causative agent. Conclusion To the best of our knowledge, this is the first report of renal abscess caused by S. bareilly.

Diagnosis and management of retroperitoneal abscesses caused by ESBL (Extended-Spectrum-β-Lactamase) Escherichia Coli require special attention. A female patient came to the Emergency Department with complaints of abdominal discomfort, bloating, nausea, fever, and urination pain for 1 week, and physical examination demonstrated an enlarged mass in the left flank for the past 6 months. Laboratory results showed an increase in leukocytes and procalcitonin hence the antibiotic cefoperazone sulbactam was given as empirical therapy. An abdominal CT scan revealed multiple retroperitoneal abscesses in the left and right hemiabdomen, therefore levofloxacin and metronidazole were given as additional antibiotics. Percutaneous abscess drainage was performed and from the pus culture obtained grew ESBL Escherichia Coli bacteria. Furthermore, antibiotics were changed to intravenous amikacin according to the results of the susceptibility test. The patient's clinical symptoms improved significantly and she was discharged and evaluated in the outpatient clinic.

The differential diagnosis of renal tumors and abscesses is crucial owing to their different treatments. Although antibacterial administration and radiological examination are excellent means for distinction, misdiagnosis is common and may lead to severe consequences, such as the need for nephrectomy. Here, we report a case involving a 52-year-old Asian woman with a renal mass for which a differential diagnosis was challenging. The mass persisted after administration of intravenous antibiotic therapy for 1 month. A computed tomography scan indicated an inflammatory lesion, whereas magnetic resonance imaging suggested a diagnosis of a tumor. Despite these indications, a right renal abscess was suspected during robot-assisted laparoscopic surgery, and nephron-sparing surgery was performed, which allowed confirmation of the final pathological result by biopsy specimen. Postoperatively, the mass gradually decreased in size after antibiotic therapy for a further month. This case, in which a renal abscess mimicked a tumor and the patient almost underwent a nephrectomy, highlights the need for caution in establishing therapeutic schedules for patients with inaccurate diagnoses. The management strategies for such patients must be reviewed and improved.

Diagnosis, and management of retroperitoneal abscesses caused by ESBL (Extended-Spectrum-βLactamase) Escherichia Coli require special attention. A female patient came to the Emergency Department with complaints of abdominal discomfort, bloating, nausea, fever, and urination pain for 1 week, and a physical examination demonstrated an enlarged mass in the left flank for the past 6 months. Laboratory results showed an increase in leukocytes and procalcitonin; hence the antibiotic cefoperazone sulbactam was given as empirical therapy. An abdominal CT scan revealed multiple retroperitoneal abscesses in the left and right hemiabdomen; therefore, levofloxacin and metronidazole were given as additional antibiotics. Percutaneous abscess drainage was performed and from the pus culture obtained grew ESBL Escherichia Coli bacteria. Furthermore, antibiotics were changed to intravenous amikacin according to the results of the susceptibility test. The patient's clinical symptoms improved significantly, and she was discharged and evaluated in the outpatient clinic. [ABSTRACT FROM AUTHOR]

Crizotinib is a tyrosine kinase inhibitor that has been found to be effective in the treatment of c-ros oncogene 1-positive non-small cell lung cancer. Although this targeted agent for treating cancer has shown superiority to standard chemotherapy in some ways, this drug has adverse effects, such as the development of renal abscesses. Some associated renal damage may disappear with crizotinib withdrawal. Hence, we present the case of a 58-year-old man with non-small cell lung cancer on crizotinib therapy who developed bilateral renal abnormal space-occupying lesions, successively which were difficult to identify using various imaging methods; even PET-CT highly suspected the right renal masses as malignant. Finally, the right renal lesions were confirmed as renal abscesses by postoperative pathology. The left renal lesion was considered as renal cysts through the lesion disappearing after crizotinib withdrawal. There have been very few reports in this respect, especially proved by various methods and confirmed by postoperative pathology. It is important to recognize this drug-related complication in order to avoid incorrect diagnosis and inadequate therapy. It is necessary to monitor renal changes after taking crizotinib. [ABSTRACT FROM AUTHOR]

Few cases of Hypervirulent Klebsiella Pneumonia (HvKP) have been described. Even fewer cases with renal abscess and metastatic pulmonary spread are reported. Typically, prompt introduction of intravenous antibiotics leads to clinical resolution and more invasive measures of source control are rarely required. To date only one other case of disseminated metastatic HvKP requiring nephrectomy for infective source control is described. Here we present a rare case of metastatic HvKP refractory to intravenous antimicrobial therapy in an immunocompromised newly diagnosed diabetic patient. Specifically, we seek to illustrate the rapid effectiveness of surgical intervention following a poor response to initial treatment.

The occurrence of combined liver and renal abscess by Candida albicans in an immunocompetent patient is a rare entity. Here, we report a 40-year-old female who presented to the hospital with complaints of fever, right flank pain, vomiting and loose stools. Contrast-enhanced computed tomography (CT) of the abdomen revealed liver and renal abscess with contracted left kidney with multiple urinary calculi and bilateral mild to moderate hydroureteronephrosis. Culture of the aspirate from abscess grew C. albicans. Blood cultures and urine cultures were sterile. She was treated with tablet voriconazole and percutaneous drainage of renal and hepatic abscess was done. Fever spikes and pain abdomen subsided after 1 week of therapy. Repeat CT abdomen after 3 weeks showed resolving liver and renal abscess.

With the advancement of ureteroscopic equipment, it has become a safe and efficient technique that is widely used in our practice for wide variety of diseases. Here we present a 65-years old patient with 2cm right renal pelvic stone, who underwent uneventful right ureteroscopic lithotripsy. She developed symptomatic right renal abscess after one week time, which was treated with antibiotics and drainage successfully. Although ureteroscopic lithotripsy is safe and efficient technique in the management of urolithiasis, careful patient monitoring postoperatively is indicated as minor and major adverse events might be encountered.

(1) Introduction and Aims: Little is known about the relationship between renal pathology and gallbladder pathology, although the two organs (the gallbladder and the right kidney) are in close proximity to one another. If a renal abscess disseminates, the gallbladder would be one of the secondary organs involved. As the bile provides a favorable environment for the development of pathogenic germs, it allows for the development of acute cholecystitis, even if calculi are absent, thus resulting in the development of acute acalculous cholecystitis. The aim of our study was to analyze the association between acute acalculous cholecystitis (AAC) and renal abscesses. (2) Methods: A department-wide retrospective cohort observational study including 67 patients with renal abscesses, with a mean age of 34.5+/−16.21 years and with five males and 62 females, was conducted. All of the patients were examined by an abdominal ultrasound. The lab tests included CBC with differential liver enzymes and serum bilirubin (in order to assess alterations in the liver function which can be associated with AAC) and serum creatinine (in order to assess the renal function). Blood culture and urine culture tests were also performed. (3) Results: Of the 67 patients with renal abscesses, eight (11.94%) were associated with acute cholecystitis: four cases (5.97%) of acalculous cholecystitis and four cases (5.97%) of calculous cholecystitis, two of which presented biliary sludge (acute micro-calculous cholecystitis). All four cases of acute acalculous cholecystitis presented with sepsis, and there was one case of septic shock at onset. We did not observe an impairment in renal function in the patients presenting with acute acalculous cholecystitis, and hepatic impairment was inconstant and moderate. All of the cases had a favorable outcome after a prompt initiation of intensive antibiotic therapy; both the renal abscess and the acute acalculous cholecystitis receded without further complications. (4) Conclusions: The association of acute acalculous cholecystitis with renal abscesses could be related to the possibility of germ dissemination from the infectious focus. In the case of a renal abscess, careful clinical, lab, and imaging exams of the gallbladder are recommended in order to ensure early therapeutic intervention in the event of an association with acute acalculous cholecystitis.

Background: Renal abscesses are relatively uncommon in children, and usually due to Gram-negative rods or Staphylococcus aureus, whereas abscesses caused by Salmonella are very rare.Case Presentation: We present the case of a previously healthy 10-year-old boy who had a renal abscess due to Salmonella bareilly. He responded well to treatment with antibiotics, and computed tomography (CT)-guided drainage of the abscess. His blood, urine and abscess aspirate cultures were sterile, but a broad-range 16S rDNA polymerase chain reaction (PCR) assay of the aspirate followed by analysis of four Salmonella genes (fliC, fliD, sopE2, and spaO) identified S. bareilly as the causative agent.Conclusion: To the best of our knowledge, this is the first report of renal abscess caused by S. bareilly. [ABSTRACT FROM AUTHOR]

Copyright of Yeni Üroloji Dergisi is the property of Ali Ihsan Tasci and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Renal abscess in children is a rare and severe form of infectious kidney disease that is responsible for several serious complications. In this report, we describe a previously healthy 5-year-old girl with a renal abscess caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli), which led to bacteremia and renal scarring. Case presentation The patient presented to our department with high fever, headache, vomiting for 2 days and high inflammatory response. We diagnosed her with a urinary tract infection and initiated treatment with ampicillin and cefotaxime. Gram-negative bacilli bacteremia was noted on day 3. On day 4, her fever persisted, and a computed tomography (CT) scan revealed a renal abscess in the left kidney. After identifying the bacteria as ESBL-producing E. coli from the blood culture, we switched to the antibiotic meropenem and continued treatment for 3 weeks. The renal abscess was not drained. Although the renal abscess was successfully treated and it disappeared, a low-density area remained in same lesion on subsequent CT scans and a dimercaptosuccinic acid renal scan performed 4 months after onset revealed renal scarring. Conclusion Given the increasing prevalence of ESBL-producing microorganisms, clinicians should be aware of the possibility of renal abscesses caused by community-acquired ESBL-producing organisms even in previously healthy children. Once a renal abscess is suspected, early diagnosis and management are important for reducing the risk of life-threating complications and renal scarring.

Xanthogranulomatous pyelonephritis (XGP) is a rare form of chronic pyelonephritis, which is challenging to diagnose because its clinical presentation mimics other entities and is commonly associated with a history of urinary tract obstruction. We report a case of XGP in a young adult without nephrolithiasis and urinary tract obstruction. A 23-year-old woman presented with intermittent abdominal pain in the right upper quadrant persisting for the last ten months. The pain was dull, poorly localized, and started spreading to the right back, right shoulder, and right thigh in the last three months. Other complaints included fever, chills, pain during urination, and nausea. The patient had a history of infrequent urination, recurrent urinary tract infections (UTIs), and a low fluid intake. A physical examination revealed that the patient had right upper quadrant abdominal tenderness and right costovertebral angle tenderness. Laboratory findings showed leukocytosis and neutrophilia. The radiological examination revealed a round mass in the superior pole of the right kidney with mixed cystic and solid components, and a well-defined margin. It further enlarged from 4.5 cm to 10.6 cm in diameter in three months. The urologist performed a total right nephrectomy. The histopathological examination showed XGP with renal abscess. Proteus mirabilis was identified from the pus specimen culture. XGP should be considered in the diagnosis of patients having chronic UTI presented with or without the findings of urinary tract obstruction.

Urogenital tuberculosis is the commonest extrapulmonary tuberculosis after lymphadenitis, with the kidneys being the most frequently affected organ. The clinical manifestation of renal tuberculosis is frequently nonspecific, leading to many overlooked cases especially in a developed country. Herein, we report a case of renal tuberculosis in a 79-year-old Caucasian lady who presented with recurrent renal abscess refractory to antibiotics. Level of evidence: Level 5 [ABSTRACT FROM AUTHOR]

Melioidosis, an infectious disease caused by Burkholderia pseudomallei , is endemic in specific regions, including Southeast Asia and Northern Australia. In Japan, where no autochthonous has been reported to date, melioidosis is a rare infectious disease. Herein, we report a case of melioidosis in a 68-year-old Japanese man with renal abscess and bacteremia, but without pneumonia. The patient presented to our hospital and was admitted for fever and chills that have persisted for two months. It was speculated that he was infected in Thailand, where his family lives because he shuttled between Thailand and Japan. Blood cultures on admission identified Burkholderia species; however, the species was unidentifiable by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Further re-examination, including culture, loop-mediated isothermal amplification, and multiplex polymerase chain reaction methods, finally identified Burkholderia pseudomallei. We treated the patient with intravenous ceftazidime for four weeks. In addition to the antibiotics administration, puncture drainage of the renal abscess was performed, and he gradually became afebrile. Intravenous ceftazidime was switched to oral sulfamethoxazole/trimethoprim on post-admission day 32, and he was discharged. After five months of oral sulfamethoxazole/trimethoprim, no recurrence was observed one year after discharge. To diagnose melioidosis, especially in non-endemic areas, a precise and thorough understanding of its epidemiology, presentation, and identification methods is necessary. [ABSTRACT FROM AUTHOR]

Acute renal infection or acute pyelonephritis (AP) denotes the process of inflammation of the renal parenchyma and its collecting system and the urothelium following infection. Uncomplicated AP commonly affects otherwise healthy, young women without structural or functional urinary tract abnormalities and without relevant comorbidities. More severe and complicated AP occurs in patients with a structurally or functionally abnormal genitourinary tract, or in persons with a predisposing medical condition like immune compromised state and diabetes. Complicated AP is characterized by a broader spectrum of clinical presentations, a wider variety of infecting organisms, and a greater risk of progression to a complication, such as intrarenal or perinephric abscess or emphysematous pyelonephritis and has the capacity to damage the organ and at times maybe life threatening. Role of imaging in renal infection is secondary, and in most situations, imaging is done to confirm the clinical diagnosis, map progression of disease in immune-compromised group of patients, or to evaluate for potential complications and therapeutic interventions. This article attempts to discuss the pathophysiology of AP from the standpoint of medical imaging and also brings out illustrative examples of various manifestations of AP and its complications. It provides imaging insight into various stages of inflammation, development of complication, and a roadmap for understanding AP through cross-sectional imaging.

Lactobacillus jensenii is a gram-positive bacillus in the female genital tract believed to be a commensal organism that inhibits the growth of more virulent pathogens. Prevotella bivia is a gram-negative bacillus species also typically commensal in the female genital tract. Lactobacillus as the primary causative agent in perinephric abscesses and bacteremia has been documented, albeit very uncommon and opportunistic. Prevotella bivia is not classically associated with perinephric abscesses but has been implicated in rare cases of pelvic inflammatory disease and tubo-ovarian abscesses. In this report, we present a 26-year-old immunocompetent woman with a recent history of nephrolithiasis treated with lithotripsy, ureteral stent placement and removal, and antibiotics who was admitted for fever and severe right flank pain. Imaging showed a right-sided renal and perinephric abscesses colonized by Lactobacillus jensenii and Prevotella bivia. Blood cultures were also positive for Lactobacillus species. Per literature review, intravenous ceftriaxone and metronidazole were administered with successful resolution of abscesses and negative repeat blood cultures. To our knowledge, this is the first case of simultaneous renal system abscesses caused by Lactobacillus and Prevotella species. Nephrolithiasis and prior antibiotics likely contributed to the opportunistic pathogenesis in this otherwise immunocompetent patient.

Citrobacter infections have emerged as now a common nosocomial pathogen. Most of the infections manifest in patients with underlying medical conditions. The features of infection can range from infections in the lower urinary tract, respiratory tract, gastrointestinal disease, or bacteremia, however renal abscesses remain uncommon. Here we present the case of a 48-year-old female with medical history of diabetes that presented with a right renal abscess secondary to Citrobacter koseri infection managed with drainage and antimicrobial treatment., Competing Interests: Conflicts of interest: The authors have no conflicts of interest to declare., (© 2024 Greater Baltimore Medical Center.)

Introduction: The Coronavirus disease-2019 (COVID-19) has been declared as a pandemic in March 2020 by the World Health Organization (WHO). Since then, this pandemic has dramatically affected the entire world, even radically influencing the way patients are framed at triage. Symptoms and tests in most cases lead to a correct diagnosis; however, error may be around the corner. Case report: A 60 years old patient was referred with weight loss, fatigue and mild fever for 3 weeks as he was working in a COVID-19 ward. After a positive swab and chest CT scan, he was admitted in the hospital and treated as mild COVID-19 patient. A CT scan performed after the patient was discharged revealed a renal lesion misidentified as a tumor then clarified to be an abscess which retrospectively appears to be the main cause of his symptoms. Conclusion: Clinicians should consider other life-threatening disease in the differential diagnosis of patients presenting with similar symptoms to minimize mistakes and avoid further unnecessary investigations. [ABSTRACT FROM AUTHOR]

Staphylococcus aureus bacteriuria (SABU) can occur in patients with S. aureus bacteremia (SAB). However, little is known on the (molecular) pathomechanisms of the renal passage of S. aureus. This review discusses the epidemiology and pathogenesis of SABU in patients with SAB and identifies knowledge gaps. The literature search was restricted to the English language. The prevalence of SABU in patients with SAB is 7.8%–39% depending on the study design. The main risk factor for SABU is urinary tract catheterization. SABU in SAB patients is associated with increased mortality. Given present evidence, hematogenous seeding—as seen in animal models—and the development of micro-abscesses best describe the translocation of S. aureus from blood to urine. Virulence factors that might be involved are adhesion factors, sortase A, and coagulase, among others. Other potential routes of bacterial translocation (eg, transcytosis, paracytosis, translocation via "Trojan horses") were identified as knowledge gaps. [ABSTRACT FROM AUTHOR]

The occurrence of combined liver and renal abscess by Candida albicans in an immunocompetent patient is a rare entity. Here, we report a 40-year-old female who presented to the hospital with complaints of fever, right flank pain, vomiting and loose stools. Contrast-enhanced computed tomography (CT) of the abdomen revealed liver and renal abscess with contracted left kidney with multiple urinary calculi and bilateral mild to moderate hydroureteronephrosis. Culture of the aspirate from abscess grew C. albicans. Blood cultures and urine cultures were sterile. She was treated with tablet voriconazole and percutaneous drainage of renal and hepatic abscess was done. Fever spikes and pain abdomen subsided after 1 week of therapy. Repeat CT abdomen after 3 weeks showed resolving liver and renal abscess. [ABSTRACT FROM AUTHOR]