title: Renal and perinephric abscesses in West China Hospital: 10-year retrospective-descriptive study.
abstract: OBJECTIVE
  To elucidate the clinical, radiological and laboratory proﬁles of renal abscess (RA) and perinephric abscess (PNA), along with related treatment and outcome.
  
  
  METHODS
  Ninety-eight patients diagnosed with RA or PNA using the primary discharge diagnoses identified from the International Statistical Classification of Diseases and Related Health Problems Tenth Edition (ICD-10) codes (RA: N15.101, PNA: N15.102) between September 2004 and December 2014 in West China Hospital were selected. Medical records including patients' characteristics, symptoms and signs, high-risk factors, radiological features, causative microorganisms and antibiotic-resistance proﬁles, treatment approaches, and clinical outcomes were collected and analyzed.
  
  
  RESULTS
  The mean age of the patients was 46.49 years with a male to female ratio of 41:57. Lumbar pain (76.5%) and fever (53.1%) were the most common symptoms. Other symptoms and signs included chills (28.6%), anorexia and vomiting (25.5%), lethargy (10.2%), abdominal pain (11.2%), flank mass (12.2%), flank fistula (2.0%), gross hematuria (7.1%), frequency (14.3%), dysuria (9.2%), pyuria (5.1%) and weight loss (1.0%). Painful percussion of the costovertebral angle (87.8%) was the most common physical finding. The main predisposing factors were lithiasis (48.0%), diabetes mellitus (33.7%) followed by history of urological surgery (16.3%), urinary tract infections (14.3%), renal function impairment (13.3%), liver cirrhosis (2.0%), neurogenic bladder (1.0%), renal cyst (1.0%), hydronephrosis (1.0%), chronic hepatitis B (1.0%), post-discectomy (1.0%) and post-colectomy (1.0%). Ultrasound (US) and computed tomography were the most valuable diagnostic tools and US was recommended as the initial diagnostic imaging choice. Escherichia coli (51.4%), Staphylococcus aureus (10.0%) and Klebsiella pneumoniae (8.6%) were the main causative microorganisms. Intravenous antibiotic therapy was necessary while intervention including surgical and nonsurgical approaches were reserved for larger abscesses, multiple abscesses, PNAs and non-responders.
  
  
  CONCLUSIONS
  Heightened alertness, prompt diagnosis, and especially proper antibiotics in conjunction with interventional approaches allow a promising clinical outcome of renal and perinephric abscesses.
authors.affiliation: Xiao-Qin Liu, Cheng-Cheng Wang, Yan-Bin Liu, Kai Liu, Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Xiao-Qin
authors.initials: XQ
authors.lastname: Liu
authors.affiliation: Xiao-Qin Liu, Cheng-Cheng Wang, Yan-Bin Liu, Kai Liu, Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Cheng-Cheng
authors.initials: CC
authors.lastname: Wang
authors.affiliation: Xiao-Qin Liu, Cheng-Cheng Wang, Yan-Bin Liu, Kai Liu, Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Yan-Bin
authors.initials: YB
authors.lastname: Liu
authors.affiliation: Xiao-Qin Liu, Cheng-Cheng Wang, Yan-Bin Liu, Kai Liu, Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Liu
keywords: Antibiotic resistance; Causative pathogens; Conservative treatment; Diagnosis; Interventional treatment; Perinephric abscess; Renal abscess