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Acute Pyelonephritis Complicated With Spontaneous Subcapsular Renal Hematoma: A Case Report.
Joana Subtil1, Rui Carvalho1, Ana Filipa Rebelo1
1Internal Medicine, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PRT.
Cureus
|December 17, 2024
Summary
A rare case of spontaneous subcapsular renal hematoma occurred in a patient with acute pyelonephritis. Persistent fever despite antibiotics prompted diagnosis, leading to conservative management.
Area of Science:
- Nephrology
- Urology
- Infectious Diseases
Background:
- Spontaneous subcapsular renal hematoma is a rare condition involving bleeding within the kidney's subcapsular or perirenal space.
- Etiologies include renal tumors, vascular diseases, cysts, or infections.
Observation:
- A 54-year-old male presented with abdominal pain and fever, initially diagnosed with acute pyelonephritis (APN).
- Despite targeted antibiotics for Klebsiella pneumoniae, the patient had persistent fever.
- An abdominal CT revealed a large subcapsular hematoma (9.1 cm × 7.9 cm × 2.8 cm).
Findings:
- The patient remained hemodynamically stable despite a drop in hemoglobin.
- Conservative medical management was chosen due to the patient's stability.
- This case highlights a rare association between APN and spontaneous subcapsular renal hematoma.
Implications:
- Spontaneous subcapsular renal hematoma should be considered in APN cases with persistent symptoms despite antibiotics.
- Management strategies range from conservative monitoring to surgical intervention based on clinical stability and etiology.
- Early recognition and appropriate management are crucial for favorable outcomes.
Keywords:
acute pyelonephritiscomplicated urinary tract infectionkidney hemorrhageklebsiella pneumoniae bacteraemiaspontaneous subcapsular renal hematomaMore Related Videos
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