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Pyelonephritis

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Dysuria referred with laboratory findings of urinary tract infection.

Patient Data

Age: 25 years
ultrasound

Right kidney shows ill-defined hyperechoic parenchymal areas without vascularity in upper pole and interpolar regions. There is no solid or cystic area in renal parenchyma. Renal artery and vein are patent. There is no calculus or back pressure change. There is urothelial thickening involving renal pelvi-calyceal system.

Left kidney and urinary bladder were normal (images not uploaded).

10th day follow up Ultrasound

ultrasound

Right kidney shows ill-defined hyperechoic parenchymal areas without vascularity in upper pole. There is an avascular anechoic area in lower polar renal parenchyma. Renal artery and vein are patent. There is no calculus or back pressure change. There is urothelial thickening involving renal pelvi-calyceal system.

Case Discussion

Initial ultrasound shows right pyelonephritis. 10th day follow-up ultrasound shows a complication - renal abscess.

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