[Renal and perinephric abscesses: a series of 44 cases].
Renal abscesses are infrequent event and may occasionally be fatal. In order to characterize its main clinical features, its diagnosis and evolution, a retrospective-descriptive study was done with cases identified between 1996 and 2006 in a teaching hospital. Forty-four cases were collected (mean age 49.9 years). Diabetes mellitus was present in 38.6%, urinary calculi in 36.4%, and previous urinary tract infection in 11.4% of the studied population. Enterobacteriaceae were the most frequent isolated microorganisms (44.4%), and 33.3% had a poli-microbial culture in abscess samples. S. aureus was rarely identified. Main therapeutic approaches were minimally invasive procedures (pigtails, percutaneous drainage or nephrostomy) in 50% followed by surgical interventions (nephrectomy or surgical debridement) in approximately 30%. Only 20.5% of patients were treated exclusively by antibiotics. Minimally invasive procedures were applied progressively after 2001 (p < 0.005). In this series case-fatality rate was 4.5%; 13.6% (n = 6) developed septic shock. Nephrectomy was performed in 9 cases (20.5%). Patients selected for nephrostomy had a lower risk for ICU admission (Odds Ratio 0.083 IC95 0.008-0.911). Renal abscesses are cause of morbidity but had a low case-fatality ratio; the therapeutic approach has changed in recent years favoring at present minimally invasive procedures.
Fullá
Juan
J
Departamento de Urología, Hospital Clínico Universidad de Chile, Santiago.
Storme
Oscar
O
Fica
Alberto
A
Varas
M Antonieta
MA
Flores
José
J
Marchant
Fernando
F
Varas
Daniel
D
D018784:Abdominal Abscess / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult