Presentation
Right flank pain, fever, malaise for four days.
Patient Data
Poor corticomedullary differentiation and multiple focal irregular areas of parenchymal hypoechogenicity in the right kidney.
Sagittally malrotated right kidney with multiple T2W hypointense and T1W relatively hyperintense foci showing restricted diffusion.
On surgical evaluation there are multiple abscesses ranging from 0.1-4.0 cm.
Case Discussion
Pyelonephritis does not normally require imaging confirmation, but a suspicion for renal abscess is an indication for advanced imaging.
Typically, treatment is a combination of antibiotics +/- percutaneous drainage of abscess(es). Surgical exploration may be necessary if there is a high risk complicating factor (e.g. emphysematous pyelonephritis) or if conservative therapies have failed to control the infection.
Thanks to Dr GM Adenova for contributing this case.
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