Related Experiment Video
Updated: Jun 19, 2026
03:42
Retroperitoneal Laparoscopic Debridement and Drainage for Pancreatic Abscess
Published on: March 15, 2024
[Lumbar panniculitis with subcutaneous abscess revealing pyonephrosis]
C Pauwels1, C Bulai-Livideanu, H Chiavassa
1Service de dermatologie, CHU Purpan, université Paul-Sabatier, place du Dr Baylac, Toulouse, France.
Annales De Dermatologie Et De Venereologie
|October 6, 2009
Summary
A rare case of bacterial hypodermitis with abscesses, secondary to pyonephrosis (kidney infection), was diagnosed in a woman. Imaging confirmed the kidney infection had spread to the skin, causing subcutaneous pus.
Area of Science:
- Dermatology
- Nephrology
- Radiology
Background:
- Pyonephrosis, a kidney infection, can present with unusual skin manifestations.
- Lumbar hypodermitis, an inflammation of the subcutaneous tissue in the lower back, may indicate deeper infections.
Observation:
- A 58-year-old woman presented with a two-month history of lumbar inflammation post-physiotherapy.
- Skin biopsy revealed septal hypodermitis; ultrasound identified a liquid collection.
- Proteus mirabilis was isolated from the collection; MRI and uroscan confirmed pyonephrosis with hypodermal spread.
Findings:
- The patient had bacterial hypodermitis with abscesses secondary to pyonephrosis.
- The infection had spread from the kidney to the subcutaneous tissue of the lumbar region.
- Diagnosis was aided by imaging techniques like MRI and uroscan.
Implications:
- Pyonephrosis can lead to cutaneous fistulas and subcutaneous abscesses, mimicking other conditions.
- Prompt diagnosis through imaging is crucial in these rare and misleading clinical scenarios.
- This case highlights the importance of considering visceral infections in unexplained skin inflammation.
Related Concept Videos
01:27Acute Pyelonephritis I: Introduction
Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
01:26Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
01:30Acute Pancreatitis II: Clinical Manifestations and Management
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
01:19Appendicitis
Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
01:25Acute Pancreatitis I: Introduction
Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...