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Perinephric abscess: an unusual late infectious complication of renal biopsy
Abstract:
Perinephric hematomas are common after percutaneous needle biopsy of the kidney and are usually clinically occult. Infectious complications in the absence of concomitant urinary tract infection, however, are unusual. A patient is reported who developed perinephric abscess (Streptococcus pneumoniae) at the site of a renal biopsy performed five years earlier. Wisdom tooth impaction and extraction occurred shortly after the biopsy. It is speculated that bacteremia of dental origin plus immunosuppressive therapy acted adjunctively to produce localization of infection in an area of previous trauma. Elective procedures that may induce transient bacteremia after percutaneous kidney biopsy may be hazardous and are best avoided. Antibiotic prophylaxis for such procedures should be considered.
Insights
Perinephric abscesses are rare after kidney biopsies. Dental procedures causing bacteremia, combined with immunosuppression, may lead to infection at prior biopsy sites.
Area of Science:
- Nephrology
- Infectious Diseases
- Surgical Complications
Background:
- Perinephric hematomas are frequent after percutaneous kidney biopsy but typically asymptomatic.
- Infectious complications are uncommon, especially without concurrent urinary tract infections.
Observation:
- A case of a patient developing a perinephric abscess (Streptococcus pneumoniae) at a renal biopsy site five years post-procedure is presented.
- The patient experienced wisdom tooth impaction and extraction shortly after the initial biopsy.
Findings:
- The study speculates that bacteremia originating from dental issues, coupled with immunosuppressive therapy, contributed to localized infection at the previous trauma site.
- This suggests a potential link between delayed infections and prior percutaneous kidney biopsy sites.
Implications:
- Elective procedures that can cause transient bacteremia post-kidney biopsy may pose risks.
- Avoiding such procedures or considering antibiotic prophylaxis is recommended for patients with a history of percutaneous kidney biopsy.