Kidney, abscess of:
A kidney abscess can be defined as the localized collection of pus in any part of the renal tissues leading to the spread of infection and other complications. It may appear as a complex lesion or intrarenal fluid collection layered by the inflammatory cells.
Based on the anatomic location of the abscess in the kidney, it can be categorized into three types,
- Perinephric Abscess: A perinephric abscess is a collection of pus in the perinephric fat (layer of fat surrounding the kidneys) and fascia surrounding the kidney.
- Renal Cortical Abscess: It is a term to describe the collection of pus in the renal cortex.
- Corticomedullary Abscess: A corticomedullary abscess is a collection of pus in the space joining the renal medulla and cortex.
Studies report that kidney abscesses resulting from focal infection usually result in abscesses in the medulla, whereas the hematogenous spread from a remote site will result in a cortical abscess. Either type can crack into the perinephric space causing a perinephric abscess.
The following are the causes of a kidney abscess:
- Abscess on the skin
- Inflammation of the kidneys
- Kidney disease
- Post-Surgery complications to the urinary tract, reproductive organs
- Drugs that were administered intravenously
- Few patients with high levels of blood glucose encounter renal abscess
Renal abscess is a rare occurrence that usually presents with the following symptoms:
- Fever and chills
- Abdominal pain that radiates down the groin
- Severe backache and tenderness
- Sudden weight loss
- Pain during urination
- Blood in the urine
- Sweating at night
Diagnostic tests include:
- Complete Blood Count: This will reveal the increased number of white blood cells (leukocytosis).
- Erythrocyte Sedimentation Rate (ESR) and C-reactive Protein (CRP): Values are elevated, indicating active infection.
- Blood Culture: Reveal the growth of organisms in the blood.
- Gram Staining: Done to understand whether the organism causing the infection is gram-positive or negative.
- Urine Test: Reveals the presence of causative bacteria and pus in the urine.
- X-ray: This is the least advisable, as small abscesses are hard to appreciate in X-ray.
- Kidney Ultrasound: Kidney ultrasound helps visualize the abscess.
- Computerized Tomography (CT scan): CT scan is the most preferred method to diagnose kidney abscesses.