A Case of Wunderlich Syndrome Caused by Pyelonephritis Due to Klebsiella pneumoniae

Wunderlich syndrome, characterized by spontaneous nontraumatic renal hemorrhage, is a rare but severe condition often presenting with Lenk's triad: acute abdominal pain, flank mass, and hypovolemic shock. While typically caused by neoplastic or vascular conditions, infection-induced Wunderlich syndrome is uncommon. This case report details an 80-year-old woman who developed Wunderlich syndrome secondary to pyelonephritis caused by Klebsiella pneumoniae. The patient presented with septic shock and was diagnosed with left subcapsular renal haematoma. Despite initial antimicrobial therapy, the patient's condition deteriorated, requiring surgical drainage. This case emphasizes the importance of considering surgical intervention in addition to antimicrobial treatment in managing Wunderlich syndrome, especially in patients with pre-existing conditions like diabetes mellitus, which increases the risk of severe complications.