Giant Pyonephrosis in an Ectopic Kidney: A Case Report

Area of Science:

• Nephrology
• Urology
• Infectious Diseases

Background:

• Pyonephrosis is infective hydronephrosis with renal parenchyma destruction, potentially impairing kidney function.
• Common causes include UTIs, urinary tract obstruction, and congenital anomalies like pelvic or horseshoe kidneys.
• Patients may be asymptomatic or present with septic symptoms such as fever, chills, and flank pain.

Observation:

• A 30-year-old female presented with acute toxic symptoms.
• She had a history of progressive abdominal swelling and pain over two years.
• The condition was diagnosed as giant pyonephrosis within an ectopic kidney.

Findings:

• The patient initially received percutaneous drainage of pus and intravenous antibiotics.
• A simple nephrectomy was performed four weeks after initial treatment.
• This management approach addressed the severe infection and anatomical abnormality.

Implications:

• Giant pyonephrosis in ectopic kidneys is a rare but serious condition requiring prompt diagnosis and management.
• Multistage treatment involving drainage, antibiotics, and surgical intervention may be necessary.
• This case underscores the importance of considering unusual presentations of pyonephrosis, especially in the presence of renal anomalies.