Case report: Xanthogranulomatous pyelonephritis successfully treated with antibiotics

Area of Science:

• Nephrology
• Pathology
• Inflammatory Diseases

Background:

• Xanthogranulomatous inflammation (XGI) is a rare benign inflammatory condition.
• Xanthogranulomatous pyelonephritis (XGP) is XGI affecting the kidney, accounting for ~5% of XGI cases.
• XGP often mimics renal malignancy on imaging, complicating diagnosis and treatment.

Observation:

• A case presented with a renal lesion suspicious for malignancy.
• Preoperative imaging failed to differentiate the lesion from cancer.
• Histopathological examination confirmed the diagnosis of XGP.

Findings:

• The patient showed significant improvement and resolution of XGP with antibiotic therapy alone.
• This challenges the current consensus favoring surgery as the primary treatment for XGP.
• Antibiotics may be a viable alternative treatment for select XGP cases.

Implications:

• This finding suggests a less invasive treatment approach for XGP may be possible.
• Further research is needed to evaluate the efficacy of antibiotics in treating XGP.
• Accurate diagnosis of XGP is crucial to avoid unnecessary radical treatments.