Related Experiment Videos
[Perinephritic cellulitis. Apropos of 75 cases]
S Bennani1, R Aboutaieb, M el Mrini
1Service d'Urologie, C.H.U. Averroès, Casablanca, Maroc.
Abstract:
In spite of the contribution of the new techniques of radiology and the use of new antibiotics, the diagnosis of perinephric abscess remains difficult and late and is at the origin of high morbidity and mortality. 75 cases of perinephric abscess collected during 15 years are reviewed. We studied the etiopathogenic, diagnostic, bacteriologic and therapeutic characteristics of this affection. Urinary signs are found in 26.7% of patients, diabetes in 17% and extra urinary origin is found in 11% of patients. Diagnostic delay is over one month in 75% of patients. Ultrasonography is carried out in 55 patients showing evocative images of perinephric abscess in 96% of cases. Computed tomography seems more performant than ultrasonography. Gram negative bacillus and staphylococcus are the germs which are the most frequently found. Surgical drainage associated to antibiotherapy is realized in all patients with collected perinephric abscess (73 cases). Evolution is often favourable in spite of the expanse of the abscedation. Literature data about pathogenesis, bacteriology, diagnosis and treatment of this affection are discussed.
Insights
Diagnosing perinephric abscess remains challenging, leading to delays and poor outcomes. Early imaging, like ultrasonography, is crucial for timely intervention in this kidney infection.
Area of Science:
- Nephrology
- Infectious Diseases
- Radiology
Context:
- Perinephric abscess poses significant diagnostic and therapeutic challenges despite advancements in medical technology.
- Delayed diagnosis contributes to high rates of morbidity and mortality associated with this condition.
Purpose:
- To review the etiopathogenic, diagnostic, bacteriologic, and therapeutic characteristics of perinephric abscess.
- To evaluate the effectiveness of diagnostic imaging modalities and treatment strategies for perinephric abscess.
Summary:
- This study analyzed 75 cases of perinephric abscess over 15 years, highlighting diagnostic delays exceeding one month in 75% of patients.
- Ultrasonography demonstrated high sensitivity (96%) in diagnosing perinephric abscess, with computed tomography showing potential for improved performance.
- Commonly identified pathogens include Gram-negative bacilli and Staphylococcus, with surgical drainage and antibiotic therapy being the standard treatment.
Impact:
- Findings underscore the need for improved diagnostic protocols to reduce delays and improve patient outcomes.
- Highlights the importance of early imaging and appropriate antibiotic selection in managing perinephric abscess.
- Emphasizes that despite extensive abscess formation, prompt treatment can lead to favorable outcomes.