Perinephric abscess: The missed diagnosis

F. N. Hutchinson, George Kaysen

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Perinephric abscess is a life-threatening but treatable process. Most infections of the perinephric space occur as a result of extension of an ascending urinary tract infection, commonly in association with nephrolithiasis or urinary tract obstruction. A large portion of the mortality is the result of failure to diagnose this entity in a timely fashion. This failure may be because of the frequently obscure or nospecific nature of the clinical presentation. Blood cultures as well as urine cultures may fail to identify correctly the bacterial pathogens responsible for the abscess. Perinephric abscess should be considered in the differential diagnosis of any patient presenting with a urinary tract infection that fails to respond promptly to antibiotic therapy, particularly in those known to have anatomical abnormalities of the urinary tract or diabetes mellitus. Consideration of this diagnosis should enter into the differential diagnosis of fever with abdominal pain or flank pain. Early recognition of perinephric abscess and prompt drainage, either percutaneously or surgically, in combination with appropriate antibiotic coverage, should reduce dramatically the morbidity and mortality from this infection.

Original languageEnglish (US)
Pages (from-to)993-1014
Number of pages22
JournalMedical Clinics of North America
Volume72
Issue number5
StatePublished - 1988

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Abscess
Urinary Tract
Urinary Tract Infections
Differential Diagnosis
Anti-Bacterial Agents
Flank Pain
Nephrolithiasis
Mortality
Infection
Abdominal Pain
Drainage
Diabetes Mellitus
Fever
Urine
Morbidity
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Perinephric abscess : The missed diagnosis. / Hutchinson, F. N.; Kaysen, George.

In: Medical Clinics of North America, Vol. 72, No. 5, 1988, p. 993-1014.

Research output: Contribution to journalArticle

Hutchinson, F. N. ; Kaysen, George. / Perinephric abscess : The missed diagnosis. In: Medical Clinics of North America. 1988 ; Vol. 72, No. 5. pp. 993-1014.
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