Renal suppurative infections: analysis of a series of 32 cases

Renal suppurative infections (RSIs), including pyonephrosis, renal abscess, and perinephric abscess, are rare but potentially life-threatening conditions. This study aimed to evaluate the epidemiological, diagnostic, therapeutic, and outcome aspects of RSIs.

We conducted a retrospective descriptive study of patients admitted for renal suppurative infections in the urology department of CHU Yalgado Ouédraogo between November 2021 and December 2023. Epidemiological, clinical, biological, radiological, and therapeutic data were analyzed.

Among 1.377 admitted patients, 32 cases of RSIs were identified (hospital prevalence: 2.32%). The mean age was 37.48 ± 15.68 years, with a female predominance (sex ratio 1.4). Fever-associated flank pain was the main presenting symptom (84.38%). Obstructive uropathy, particularly urolithiasis and schistosomiasis-related ureteral lesions, was the main etiological factor. Pyonephrosis was the most frequent diagnosis (68.75%). All patients underwent ultrasonography, complemented by computed tomography in 78.12% of cases. Biological findings showed anemia, leukocytosis, and impaired renal function in a substantial proportion of patients. Escherichia coli was the most frequently isolated pathogen. Management combined broadspectrum antibiotic therapy and systematic percutaneous drainage. Secondary etiological surgery was performed in 56.06% of cases. The mean hospital stay was 30.13 ± 26.83 days. The mortality rate was 12.9%, mainly associated with underlying malignancy.  Conclusions: RSIs remain severe infections requiring prompt diagnosis and multidisciplinary management. Early antibiotic therapy combined with effective drainage improves outcomes; however, prognosis is strongly influenced by underlying comorbidities. Optimizing the management of obstructive uropathies and associated conditions is essential to reduce morbidity and mortality.