renal abcess

2. ADULT HEALTH NURSING

3. OBJECTIVES
Define renal abscess
 Etiology
Factors of renal abscess
Discuss the clinical features
 Investigation
Diagnosis
 Treatment of renal abscess
Ultrasound
 Complication of renal abscess
Infection of renal abscess

4. DEFINITION
Renal abscess is a collection of pus
around kidney. Pus is formed following
infection of soft tissue around kidney or
infection of peripheral kidney tissue. Renal
abscess is and uncommon disease caused
by trauma and infection associated with
kidney stone.

6. ETIOLOGY :
Staphylococcus aurous :release from
distance sources
Injury to the kidney
E.coil (Escherichia coli)

7. PATHOLOGY OF RENAL ABSCESS
 Glomerular diseases
 Acute pyelonephritis
 Vascular disease
 Acute tubular necrosis
 Kidney stones (Urolithiasis)
 End stage renal disease
 Cancer

8. CAUSES OF RENAL ABSCESS
• Urinary tract infection – infection of ureter,
bladder and urethra may spread in to
kidney causing pyelonephritis and kidney
abscess
• Bacteremia ….
• Urinary tract stone….
• Kidney inflammation….

9. RISK FACTOR OF RENAL ABSCESS
 Diabetes Mellitus
 Pregnancy
 Elderly Patients – 65 years and over
 Sickle Cell Disease
 Autoimmune Disease

10. CLINICAL FEATURES
 Symptoms:
• Fever, chills, loin pain
• Weight loss
• Excessive Sweating
• Abdominal pain
• Hypotension
• Bloody Urine
 Signs:
Extreme tenderness over the affected kidney.

11. DIAGNOSIS
Urine Examination :
• Hematuria – Blood in urine
• Proteiuria – Protein in urine
• Blood Examination
• Hemoglobin – Decrease hemoglobin is a sign of anemia
• Increase white blood cell count
• Blood Culture
X – ray Finding
• Radiopaque shadow observed around if abscess is large.

12. Ultrasound
• Kidney Abscess is observed around kidney – a
diagnostic finding of large perirenal abscess .
• Size of kidney is enlarged suggesting possible
renal abscess .
CT Scan and MRI
• CT scan and MRI differentiate the intra – renal
(inside kidney tissue ) and extra - renal ( outside
kidney abscess
CONT.

13. Blood: elevated WBC
Urine:
usually negative in the early stages
Pus cells & bacteria if the abscess ruptures into the
renal pelvis
X- ray: enlarged kidney
IVU : Space occupying lesion obliterating or
compressing group of Calyces & or a part of
the ureter
InvestigationsInInvestigationsvestigations

14. TREATMENT
Antibiotics
o Oral
o Intravenous
Nephrectomy
Hypertension
o Ace inhibitors
14

15. CONT.
Diabetes
o Metformin
o Insulin
 Percutaneous Drainage
o Abscess is a drained from outside and catheter is left
for continuous drain and daily injection of antibiotics .

16. ULTRASOUND

17. COMPLICATION
Emphysematous Pyelonephritis (EPN)
o Emphysematous Pyelonephritis (EPN) is a
serious complication that result rapid
deterioration of general condition and
destruction of kidney tissue.
o Complication is observed in diabetic patients
only.
Kidney Failure
o Kidney infection can cause severe kidney
damage that results in kidney failure.

18. INFECTION
 Appendicitis
Inflammation of the vermiform appendix
 Diverticulitis
Inflammation of a diverticulum in the
digestive tract
 Perinephric Abscess
 Renal Abscess

19. REFERENCES
Renal cortical micro abscesses as cause of
reversible acute renal failure.
Renal and perirenal abscesses in patients with
otherwise
Anatomically normal urinary tract .