Renal Corticomedullary Abscess Follow-up

  • Author: Aaron Benson, MD; Chief Editor: Edward David Kim, MD, FACS   more...
 
Updated: Nov 21, 2011
 

Complications

The most feared complication of corticomedullary abscess is potential extension of the abscess through the renal capsule, resulting in a perinephric abscess. Gerota fascia usually contains the abscess within the perinephric space, but the process may extend into the retroperitoneum to infect adjacent structures. In these situations, simple nephrectomy is challenging because adjacent organs, such as the pancreas and bowel, may be involved.

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Prognosis

  • Acute focal bacterial nephritis usually responds to antimicrobial therapy alone. Follow-up radiographic studies typically show complete resolution of the intrarenal lesion.
  • Conversely, patients with acute multifocal bacterial nephritis take longer to improve with antibiotics alone. Occasionally, patients require some form of a drainage procedure.
  • In most situations, patients with large abscesses or xanthogranulomatous disease who require open surgical procedure fully recover, albeit with a higher degree of morbidity.
  • Prognosis improves with early recognition of symptoms and early aggressive therapy. Poor prognosis factors include advanced age, urosepsis, anatomic abnormalities, advanced disease, and impaired renal function at presentation.
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Patient Education

For excellent patient education resources, visit eMedicine's Infections Center and Kidneys and Urinary System Center. Also, see eMedicine's patient education articles Urinary Tract Infections and Antibiotics.

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Contributor Information and Disclosures
Author

Aaron Benson, MD  Staff Physician, Department of Surgery, Division of Urology, Southern Illinois University School of Medicine

Aaron Benson, MD is a member of the following medical societies: American Medical Association, American Urological Association, and Illinois State Medical Society

Disclosure: Nothing to disclose.

Coauthor(s)

Thomas H Tarter, MD, PhD  Associate Professor, Department of Surgery, Division of Urology, Director of Urologic Oncology, Simmons Cooper Cancer Institute, Southern Illinois University School of Medicine

Thomas H Tarter, MD, PhD is a member of the following medical societies: American College of Surgeons Oncology Group, American Medical Association, American Urological Association, and Society of Urologic Oncology

Disclosure: Illinois Cryotherapy Enterprise Ownership interest Other

Julius Lynn Teague, MD, FACS, FAAP  Medical Director, Pediatric Urology, Greenville Hospital System Children's Hospital

Julius Lynn Teague, MD, FACS, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, American Urological Association, and Christian Medical & Dental Society

Disclosure: Nothing to disclose.

Keith Steinbecker, MD  Consulting Staff, Department of Urology, St John's Mercy Medical Center

Keith Steinbecker, MD is a member of the following medical societies: American Urological Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Shlomo Raz, MD  Professor, Department of Surgery, Division of Urology, University of California at Los Angeles School of Medicine

Shlomo Raz, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, and California Medical Association

Disclosure: Nothing to disclose.

J Stuart Wolf Jr, MD, FACS  The David A Bloom Professor of Urology, Director, Division of Endourology and Stone Disease, Department of Urology, University of Michigan Medical School

J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology

Disclosure: Nothing to disclose.

Chief Editor

Edward David Kim, MD, FACS  Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center

Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, Sexual Medicine Society of North America, and Tennessee Medical Association

Disclosure: Lilly Consulting fee Advisor; Astellas Consulting fee Speaking and teaching; Watson Consulting fee Speaking and teaching; Allergan Consulting fee Speaking and teaching

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Contrasted CT scan that demonstrates a corticomedullary abscess in a 27-year-old patient with diabetes mellitus who has a history of multiple urinary tract infections. Note the heterogeneous hypodense lesion in the right kidney. Extracapsular extension is not present.
 
 
 
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