Renal and perirenal abscesses

Infect Dis Clin North Am. 1997 Sep;11(3):663-80. doi: 10.1016/s0891-5520(05)70379-2.

Abstract

Our knowledge of the spectrum of renal abscesses has evolved as a result of more sensitive radiologic techniques. The classification of intrarenal abscesses currently includes acute focal bacterial nephritis, acute multifocal bacterial nephritis, renal cortical abscess, renal corticomedullary abscess, and xanthogranulomatous pyelonephritis. The clinical presentation of these entities does not differentiate them, however, and various radiographic studies are helpful in making the diagnosis. The intrarenal abscess is usually treated successfully with antibiotic therapy alone. Antistaphylococcal therapy is indicated for the renal cortical abscess, whereas therapy directed against the common gram-negative uropathogens is indicated for most of the other entities. The perinephric abscess is often an elusive diagnosis, has a more serious prognosis, and is more difficult to treat. Drainage of the abscess and sometimes partial or complete nephrectomy, in addition to antibiotic therapy, are required for resolution.

Publication types

  • Review

MeSH terms

  • Abscess / diagnosis*
  • Abscess / drug therapy
  • Abscess / etiology*
  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Female
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / drug therapy
  • Humans
  • Kidney / diagnostic imaging
  • Kidney Diseases / diagnosis
  • Kidney Diseases / drug therapy
  • Kidney Diseases / microbiology*
  • Male
  • Radionuclide Imaging
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / drug therapy
  • Tomography, X-Ray Computed
  • Ultrasonography

Substances

  • Anti-Bacterial Agents