Monday, December 14, 2020

Renal and Perinephric Abscesses

emDocs - December 13, 2020 - By Christian Capanna
Reviewed by: Edward Lew; Alex Koyfman; Brit Long
"Take Home Points
  • Renal and perinephric abscesses are serious, often missed diagnoses in the emergency department that are important for emergency clinicians to keep on their differential, as only 35% of renal and perinephric abscesses are correctly diagnosed in the emergency department.
  • UA is not necessarily consistent with these infections unless the abscess involves the collecting system.
  • Mortality of renal and perinephric abscesses can be as high as 14%.
  • CT scan is the single best way to diagnosis these disease processes, but bedside ultrasound can offer a quicker diagnosis in some.
  • Broad-spectrum antibiotics are the mainstay of treatment for all confirmed diagnoses and the size of the abscess (>5cm) will determine need for drainage.
  • All patients with confirmed diagnosis should be admitted for continued antibiotics, culture results and urology consultation."