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Abstract:
The aetiology of the paranephric abscess has been greatly modified since the introductiion of antibiotics. Its frequency has decreased but its prognosis has not been improved. 20 cases of paranephric abscess have been studied retrospectively. Its main cause is no longer the haematogenic staphylococcus infection but primary kidney infection. The disease is difficult to diagnose as the evolution is slow and the symptoms unspecific. The main symptoms are: abdominal pain, feeling of physical prostation, subfebrility, acute pain in the flank and significant increase in blood sedimentation rate. The infection is due in most cases to a silent kidney or a kidney stone with pyonephrosis. Accompaying diabetes mellitus was often observed.
Insights
Paranephric abscesses are now mainly caused by primary kidney infections, not staphylococcus. Diagnosis remains challenging due to slow progression and non-specific symptoms, impacting patient prognosis.
Area of Science:
- Nephrology
- Infectious Diseases
- Urology
Background:
- The introduction of antibiotics has significantly altered the causes of paranephric abscess.
- While antibiotic use has decreased the frequency of paranephric abscesses, their prognosis has not improved.
Purpose of the Study:
- To retrospectively analyze 20 cases of paranephric abscess to understand current etiological factors and diagnostic challenges.
- To identify the primary causes and common symptoms of paranephric abscess in the antibiotic era.
Main Methods:
- Retrospective case study analysis of 20 patients diagnosed with paranephric abscess.
- Review of patient records to identify etiological factors, clinical presentation, and associated conditions.
Main Results:
- The primary cause has shifted from Staphylococcus aureus hematogenous infection to primary kidney infections.
- Common presenting symptoms include abdominal pain, malaise, low-grade fever, flank pain, and elevated erythrocyte sedimentation rate.
- Associated conditions frequently observed include silent kidney infections, kidney stones with pyonephrosis, and diabetes mellitus.
Conclusions:
- Paranephric abscess etiology has evolved, with primary kidney infections now being the predominant cause.
- The disease presents diagnostic difficulties due to insidious onset and nonspecific symptoms, necessitating high clinical suspicion.
- Effective management requires early diagnosis and treatment, often in the context of underlying renal pathology or diabetes.