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Images of Memorable Cases: Case 18

Module by: Herbert L. Fred, MD, Hendrik A. van Dijk

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Case_18-pres1-1.jpg Case_18-pres1-2.jpg

Plain abdominal radiographs of a 72-year-old man with fever, chills, dysuria, and right flank pain. Urinalysis showed proteinuria, pyuria, and gram-negative rods.

18. Perinephric abscess

In a patient thought to have acute pyelonephritis, the presence of air encircling the kidney is pathognomonic of perinephric abscess. Drainage of this patient’s abscess yielded purulent material containing Proteus mirabilis.

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