Massive hematuria due to right renal artery mycotic pseudoaneurysm in a patient with subacute bacterial endocarditis.
A 40-year-old woman with recently diagnosed bacterial endocarditis was admitted to the hospital with gross hematuria and anemia. Computed tomography revealed a large right upper pole renal artery pseudoaneurysm, a wedge-shaped hypoperfused region of the left kidney, and a splenic abscess. Radiographic embolization of the right renal artery was performed to stabilize the bleeding. The splenic abscess was drained. Subsequent right nephrectomy and splenectomy were performed for persistent leukocytosis. This unusual presentation of a septic embolus and its management are discussed.
Ohebshalom
M M
MM
James Buchanan Brady Foundation, Department of Urology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, New York 10021, USA.
Tash
J A
JA
Coll
D
D
Su
L M
LM
Schlegel
P N
PN
D000038:Abscess / Q000150:complications; D000328:Adult; D017541:Aneurysm, False / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D000785:Aneurysm, Infected / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D004621:Embolization, Therapeutic; D004697:Endocarditis, Bacterial / Q000150:complications*; D005260:Female; D006333:Heart Failure / Q000150:complications; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D007238:Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D007964:Leukocytosis / Q000150:complications; D009392:Nephrectomy; D012078:Renal Artery Obstruction / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D013156:Splenectomy; D013158:Splenic Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D013290:Streptococcal Infections / Q000150:complications; D014057:Tomography, X-Ray Computed