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Perinephric Fat Stranding on Postmortem Computed Tomography Scan in Acute Pyelonephritis: A Case Report
Jack Garland1, Kelly Olds2, Rexson Tse3
1From the Forensic & Analytical Science Service, NSW Health Pathology, New South Wales.
Summary
Postmortem CT scans can reveal perinephric fat stranding, a key indicator of acute pyelonephritis. This finding aids pathologists in identifying kidney inflammation during postmortem examinations.
Area of Science:
- Forensic Radiology
- Pathology
- Medical Imaging
Background:
- Solid organ infection/inflammation can be challenging to detect via postmortem computed tomography (PMCT).
- Perinephric fat stranding is a known CT finding for pyelonephritis in clinical settings.
- Documentation of perinephric fat stranding on PMCT for acute pyelonephritis is absent in forensic literature.
Observation:
- A case of death due to acute pyelonephritis with hypertensive heart disease was investigated.
- Unenhanced PMCT revealed significant bilateral perinephric fat stranding prior to autopsy.
- This imaging finding directed the pathologist's focus towards the kidneys.
Findings:
- The PMCT demonstrated clear perinephric fat stranding.
- Microbiology specimens were collected based on the PMCT findings.
- The diagnosis of acute pyelonephritis was confirmed.
Implications:
- Perinephric fat stranding on PMCT may serve as a valuable indicator for acute pyelonephritis.
- This sign can alert pathologists to prioritize kidney examination and sampling.
- Enhances diagnostic accuracy in postmortem evaluations of renal infections.
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