Recent clinical overview of renal and perirenal abscesses in 56 consecutive cases.
OBJECTIVE
The aim of this study was to examine the recent clinical trends and antibiotic susceptibilities of the causative microorganisms in renal and perirenal abscesses, and to elucidate the factors associated with treatment strategies.


METHODS
We retrospectively analyzed 56 patients who were diagnosed with renal and perirenal abscesses at our hospital from January 2000 to September 2007.


RESULTS
The mean age of the patients was 53.5 years, and a female predominance of patients (75%) was observed. Diabetes mellitus (44.6%) was the most common predisposing condition. The mean duration of symptoms before diagnosis was 11.6 days, and fever (75%) was the most common symptom. Escherichia coli (44%) and Klebsiella pneumoniae (28%) were common pathogens, and the rates of susceptibility of E. coli isolates to ampicillin, cephalothin, cefotaxime, trimethoprim-sulfamethoxazole, ciprofloxacin, gentamicin, and imipenem were 18.2%, 27.3%, 72.7%, 72.7%, 63.6%, 63.6%, and 100%, respectively. Abscesses were classified according to the location as follows: renal abscess (n=31, 55.4%) and perirenal abscess +/- renal abscess (n=25, 44.6%). In the renal abscess group, the infection rate of gram-negative organisms was higher than in the perirenal abscess group. Patients were also divided according to the treatment modality: antibiotics only (n=20, 35.7%) and percutaneous intervention or surgery (n=36, 64.3%). Patients who had a perirenal abscess or a large renal abscess required more invasive treatment.


CONCLUSIONS
This study revealed somewhat different results from those of previous studies. Clinical and microbial differences were observed between the renal and perirenal abscess groups. Abscess location and the size of the renal abscess were the factors associated with treatment strategies.
Lee
Bong Eun
BE
Department of Internal Medicine, Pusan National University College of Medicine, 1-10 Ami-dong, Seo-gu, Busan, Korea.
Seol
Hee Yun
HY
Kim
Tae Kyung
TK
Seong
Eun Young
EY
Song
Sang Heon
SH
Lee
Dong Won
DW
Lee
Soo Bong
SB
Kwak
Ihm Soo
IS
D018784:Abdominal Abscess / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D007668:Kidney / Q000382:microbiology*; D007674:Kidney Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
Scand J Urol Nephrol. 2003;37(2):139-44
12745723
Am Surg. 1969 Jan;35(1):72-5
5765651
J Urol. 1967 Sep;98(3):296-302
6057852
J Urol. 1985 Mar;133(3):375-8
3883000
J Urol. 1994 Apr;151(4):847-51
8126807
J Urol. 1982 Mar;127(3):425-6
7038147
Medicine (Baltimore). 1974 Nov;53(6):441-51
4612295
Pediatr Surg Int. 2003 Apr;19(1-2):35-9
12721720
Arch Intern Med. 1980 Jul;140(7):914-6
6992728
J Urol. 1996 Jan;155(1):52-5
7490896
Urology. 1980 Oct;16(4):333-8
7414775
Br J Urol. 1977 Feb;49(1):22
837043
AJR Am J Roentgenol. 1982 Dec;139(6):1111-5
6983254
J Urol. 2002 Oct;168(4 Pt 1):1337-40
12352387
J Urol. 1972 Apr;107(4):524-6
5014349
World J Surg. 2007 Feb;31(2):431-6
17219288
Infect Dis Clin North Am. 1997 Sep;11(3):663-80
9378929
Med Clin North Am. 1988 Sep;72(5):993-1014
3045458
J Urol. 1980 Oct;124(4):446-7
7420583
J Urol. 1987 Feb;137(2):191-4
3806801