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Spontaneous Renal Hemorrhage Secondary to MRSA Renal Abscess Requiring Nephrectomy After Failed Percutaneous
Yuichiro Atagi1, Kyotaro Fukuta1, Keisuke Ozaki1
1Department of Urology Tokushima Prefectural Central Hospital Tokushima Tokushima Prefecture Japan.
Introduction:
Spontaneous renal hemorrhage (SRH) caused by renal infection is extremely rare. Furthermore, sepsis caused by methicillin-resistant Staphylococcus aureus (MRSA) has a high mortality rate and requires prompt source control.
Case Presentation:
A 63-year-old man with severe diabetes presented to the emergency department in shock. Computed tomography revealed a left renal subcapsular hematoma. Based on his clinical course and history, infection-induced SRH was suspected. Blood and urine cultures yielded MRSA. Although percutaneous drainage was performed after the initial bleeding stabilized, persistent infection was followed by rebleeding, necessitating left nephrectomy. The patient recovered postoperatively. Histopathology confirmed abscess formation and chronic inflammation without malignancy.
Conclusion:
For inadequately controlled infections following percutaneous drainage, particularly when recurrent hemorrhage is suspected, early nephrectomy may be considered for definitive source control.
