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Perirenal abscess

Perinephric abscess

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

Causes

Most perirenal abscesses are caused by urinary tract infections that start in the bladder. They then spread to the kidney, and to the area around the kidney. Surgery in the urinary tract or reproductive system or a bloodstream infection can also lead to a perirenal abscess.

The biggest risk factor for perirenal abscess is kidney stones, by blockage of urine flow. This provides a place for an infection to grow. Bacteria tend to stick to the stones and antibiotics cannot kill the bacteria there.

Stones are found in 20% to 60% of people with perirenal abscess. Other risk factors for perirenal abscess include:

  • Diabetes
  • Having an abnormal urinary tract
  • Trauma
  • IV drug use

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
  • Sweating

Exams and Tests

The health care provider will examine you. You may have 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), then can switch to pills when infection starts improving.

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. This can be deadly.

Possible Complications

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

You may need to have the infection surgically removed.

You may have to have the kidney removed if infection cannot be cleared or is recurrent. This is rare.

When to Contact a Medical Professional

Contact your provider if you have a history of kidney stones and develop:

Prevention

If you have kidney stones, ask your provider 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 HF, Sakoulas G. Staphylococcal infections. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 272.

Cooper KL, Badalato DM, Rutman MP. Infections of the urinary tract. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 55.

Nicolle LE. Urinary tract infection in adults. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 36.

  • Kidney anatomy

    Kidney anatomy - illustration

    The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production.

    Kidney anatomy

    illustration

  • Kidney - blood and urine flow

    Kidney - blood and urine flow - illustration

    This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.

    Kidney - blood and urine flow

    illustration

    • Kidney anatomy

      Kidney anatomy - illustration

      The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production.

      Kidney anatomy

      illustration

    • Kidney - blood and urine flow

      Kidney - blood and urine flow - illustration

      This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.

      Kidney - blood and urine flow

      illustration


     

    Review Date: 1/10/2021

    Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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