Wang I-Kuan, Chen Yu-Ming, Chen Yung-Chang, Fang Ji-Tseng, Hang Chiu-Ching
Department of Nephrology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, Republic of China.
Ren Fail. 2003 Jul;25(4):653-7. doi: 10.1081/jdi-120022558.
Renal abscesses in patients with end stage renal disease are quite rare, and misdiagnosis or delaying in diagnosis is frequent. This report examines a case of renal abscess in a patient with end stage renal disease on maintenance hemodialysis and diabetes mellitus, which presented with a prolonged fever. An infected diabetic foot was impressed initially. Purulent urine, pyuria, bacteriuria, and bacteremia were noted after admission. Renal abscess was diagnosed by percutaneous needle aspiration under computerized tomography guidance. The patient was treated with parenteral antibiotics and percutaneous aspiration of the abscess. Follow-up ultrasonography showed renal abscess resolution. This case demonstrated that nephrectomy was not required in selected uremic patients with renal abscess.
终末期肾病患者发生肾脓肿相当罕见，误诊或诊断延误情况很常见。本报告探讨了一例维持性血液透析且患有糖尿病的终末期肾病患者发生肾脓肿的病例，该患者持续发热。最初考虑为感染性糖尿病足。入院后发现脓性尿、脓尿、菌尿和菌血症。在计算机断层扫描引导下经皮穿刺抽吸确诊为肾脓肿。患者接受了胃肠外抗生素治疗及脓肿经皮抽吸治疗。随访超声检查显示肾脓肿消退。该病例表明，部分患有肾脓肿的尿毒症患者无需进行肾切除术。
