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Computed tomography of renal abscesses complicating medullary sponge kidney
1Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City.
Abstract:
Although urinary tract infection occurs in approximately one-third of symptomatic patients with medullary sponge kidney (MSK), renal abscess is a rare complication of the disorder. We describe two patients with MSK complicated by renal abscesses that were diagnosed by CT. The diagnosis of renal abscess should be suspected in patients with MSK and acute pyelonephritis who do not respond to appropriate antibiotic therapy, and renal CT should be done. Computed tomography may show large abscesses that require percutaneous or open surgical drainage or small abscesses that require prolonged high dose antibiotic therapy.
Insights
Renal abscess is a rare complication of medullary sponge kidney (MSK). Early CT diagnosis in patients with MSK and pyelonephritis unresponsive to antibiotics is crucial for effective treatment.
Area of Science:
- Nephrology
- Radiology
- Infectious Diseases
Background:
- Medullary sponge kidney (MSK) is a congenital renal malformation.
- Urinary tract infections (UTIs) are common in MSK patients, affecting about one-third.
- Renal abscess is an uncommon but serious complication of MSK.
Observation:
- This report details two cases of MSK with renal abscesses.
- Computed tomography (CT) was instrumental in diagnosing the renal abscesses.
- Patients presented with symptoms suggestive of acute pyelonephritis.
Findings:
- Renal abscesses in MSK patients may not respond to standard antibiotic treatment.
- CT imaging can effectively identify renal abscesses.
- Treatment strategies vary based on abscess size, including drainage or prolonged antibiotics.
Implications:
- Clinicians should consider renal abscess in MSK patients with persistent pyelonephritis.
- Prompt CT imaging is recommended for suspected renal abscesses.
- Tailored treatment based on CT findings can improve patient outcomes in MSK-associated renal abscesses.