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Perirenal abscess
Definition
Perirenal abscess is a pocket of pus caused by an infection around one or both kidneys.
Alternative Names
Perinephric abscess
Causes
Most perirenal abscesses are caused by urinary tract infections that start in the bladder, spread to the kidney, and then spread to the area around the kidney. Surgery in the urinary tract or reproductive system and a bloodstream infection can also lead to a perirenal abscess.
The biggest risk factor for perirenal abscess is kidney stones that block the flow of urine and provide a place for an infection to grow. Bacteria tend to stick to the stones and antibiotics can't kill the bacteria there.
Stones are found in 20 - 60% of patients with perirenal abscess. Other risk factors for perirenal abscess include:
- Diabetes
- Having an abnormal urinary tract
- Trauma
Symptoms
Symptoms of perirenal abscess include:
- Chills
- Fever
- Pain in the flank (side of the abdomen) or abdomen, which may extend to the groin or down the leg
- Sweats
Exams and Tests
The doctor or nurse will examine you. You may have tenderness in the back or abdomen.
Tests include:
- Blood culture
- CT scan of the abdomen
- Ultrasound of the abdomen
- Urinalysis
- Urine culture
Treatment
To treat perirenal abscess, the pus can be drained through a catheter that is placed through the skin or with surgery. Antibiotics should also be given, at first through a vein (IV).
Outlook (Prognosis)
In general, quick diagnosis and treatment of perirenal abscess should lead to a good outcome. Kidney stones must be treated to avoid further infections.
In rare cases, the infection can spread beyond the kidney area and into the bloodstream, which can be deadly.
Possible Complications
If you have kidney stones, the infection may not go away.
When to Contact a Medical Professional
Call your health care provider if you have a history of kidney stones and develop:
- Abdominal pain
- Burning with urination
- Chills
- Fever
- Urinary tract infection
Prevention
If you have kidney stones, ask your doctor about the best way to treat them to avoid a perirenal abscess. If you undergo urologic surgery, keep the surgical area as clean as possible.
References
Chambers HL. Staphylococcal infections. In: Goldman L,Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 296.
Schaeffer AJ, Schaeffer EM. Infections of the urinary tract. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 10.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
