1300. Renal and perinephric abscesses: analysis of 61 consecutive cases
Session: Poster Abstract Session: Below the Diaphragm
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background: Renal and perirenal abscesses are uncommon disease entities resulting from infections in or around the kidneys. Diagnosis and proper treatment of renal abscesses remains a challenge for physicians. We investigated the characteristics and comorbidity factors of renal abscesses. 

Methods: Between January 2008 and December 2012 the records of 61 patients diagnosed at a 1200-bed tertiary care medical centre with renal or perirenal abscesses were retrospectively reviewed. Renal abscesses were diagnosed with imaging studies such as abdominal CT or sonography and only included the renal capsule and perirenal abscesses within Gerota’s fascia. We analyzed patient characteristics, abscess location and size, predisposing factors, clinical presentation, microbiology, laboratory data, treatment, outcome.

Results: Most patients were women (50/61, 82%), and their mean age was 50.7 ± 15.8 years. The mean size of abscesses was 2.4 ± 1.7 cm. The most common predisposing condition was diabetes mellitus (26/61, 42.6%). Common clinical features were fever (53/61, 86.8%) and flank pain (36/61, 59.1%). Urine cultures were positive in 36 (59%) patients and blood cultures in 15 (24.6%). These 13 (21.3%) patients with positive blood cultures had the same organism in urine cultures. The most frequently isolated pathogen was E. coli (30/61, 49.2%). Others included K. pneumonia (8/61, 13.1%) and unknown pathogen (20/61, 32.8%). Of the 31 cases E. coli, 6 cases were ESBL-producing pathogen. The right side (40/61, 65.6%) and mid portion were the predominant sites. Bilateral abscesses were observed in 4 cases. Of the 61 patients, 11 (18%) patients with renal abscesses underwent percutaneous abscess drainage or aspiration and 50 (82%) abscesses were treated with intravenous antibiotics alone. The mean antibiotics treatment duration was 26.6 ± 7.7 days and mean hospital stay was 13.9 ± 7.3 days. All patients showed complete clinical regression and resolution of the renal lesions shown by CT or sonography.

Conclusion: Renal abscesses can be managed by medical treatment only, reserving interventional treatment for large collections or patients with clinical impairment. Significant predictors of a long hospital stay were age, abscess size, and diabetes history.

Song Mi Moon, M.D., Su Young Kim, M.D., Kang Lock Lee, M.D., Yoon Soo Park, M.D. and Yong Kyun Cho, M.D., Department of Infectious Disease, Gachon University Gil Hospital, Incheon, South Korea

Disclosures:

S. M. Moon, None

S. Y. Kim, None

K. L. Lee, None

Y. S. Park, None

Y. K. Cho, None

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