Perirenal abscess

Kidney anatomy — The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and stimulating red blood cell production.

Also known as: Perinephric abscess

Definition

Perirenal abscess is a pocket of pus caused by an infection around one or both kidneys.

Causes, incidence, and risk factors

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. Other causes of perirenal abscess include surgery in the urinary tract or reproductive system and bloodstream infection.

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

Signs and tests

Signs of perirenal abscess include tenderness in the back or abdomen.

Tests include:

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).

Expectations (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.

Complications

If you have kidney stones, the infection may not go away.

Calling your health care provider

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

Archer GL. Staphylococcal infections. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 310.

Sobel JD, Kaye D. Urinary tract infections. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 69.

Review date:: September 3, 2010
Reviewed by:: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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