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Renal abscess

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Right flank pain, fever and pyuria.

Patient Data

Age: 15 years
Gender: Female
ct

Right renal upper pole rounded lesion measuring 4 x 4.5 x 3.5 cm for the intrarenal component. It shows necrotic core and radiating thin septations as well as perifocal edema. It exerts a mass effect in the form of splaying of the upper calyx. It is continuous with a superior anterior pararenal collection extending to the liver (segment VII) measuring 3.7 x 4 x 3.5 cm with perifocal edema. Small enlarged aortocaval and left paraaortic lymph nodes are noted.

Case Discussion

The clinical data and imaging features are consistent with right renal upper pole abscess with anterior pararenal extension and hepatic extension forming abscess at segment VII. Treatment can be percutaneous drainage or a course of antibiotics.

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