title: An unusual presentation of xanthogranulomatous pyelonephritis: psoas abscess with reno-colic fistula.
abstract: Xanthogranulomatous pyelonephritis (XGP) is a rare histological subset of pyelonephritis characterized by being a chronic destructive granulomatous inflammation of the renal parenchyma. XGP is classified according to the extent of disease into two entities: within the renal cortex (focal or segmental XGP) or diffuse spread with pelvic communication (diffuse XGP). Although rare, XGP can have fatal complications including perinephric, psoas abscess, nephro-cutaneous fistula and reno-colic fistula. Only few studies have reported XGP complicated with psaos abcess and reno-colic fistula. Our aim is to add to the literature and share our experience with a case of extensive XGP eroding into the psoas muscle and ascending colon leading to severe sepsis that was successfully managed. We report a 56-year-old woman who was found to have XGP complicated by psoas abscess and reno-colic fistula managed by antibiotics, nephrostomy, and subsequent nephrectomy and partial colectomy.
authors.affiliation: Division of Internal Medicine , Steward Carney Hospital , Tufts School of Medicine , Dorchester, MA , USA.
authors.forename: Hassan M
authors.initials: HM
authors.lastname: Ghoz
authors.affiliation: Division of Surgery , Steward Carney Hospital , Tufts School of Medicine , Dorchester, MA , USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Williams
authors.affiliation: Division of Pathology , Steward Carney Hospital , Tufts School of Medicine , Dorchester, MA , USA.
authors.forename: Aleksandr
authors.initials: A
authors.lastname: Perepletchikov
authors.affiliation: Division of Pulmonology and Critical Care , Steward Carney Hospital , Tufts School of Medicine , Dorchester, MA , USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: James
authors.affiliation: Division of Urology , Steward Carney Hospital , Tufts School of Medicine , Dorchester, MA , USA.
authors.forename: Abdulrahman A
authors.initials: AA
authors.lastname: Babeir