Renal Corticomedullary Abscess Follow-up

Updated: Dec 06, 2015
  • Author: Aaron Benson, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Follow-up

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

See the list below:

  • 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 eMedicineHealth's Infections Center. Also, see eMedicineHealth's patient education articles Urinary Tract Infections and Antibiotics.

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