Patterson J E, Andriole V T
Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.
Infect Dis Clin North Am. 1987 Dec;1(4):907-26.
Our knowledge of the spectrum of renal abscesses has increased as a result of more sensitive radiologic techniques. The classification of intrarenal abscess now includes acute focal bacterial nephritis and acute multifocal bacterial nephritis, as well as the previously recognized renal cortical abscess, renal corticomedullary abscess, and xanthogranulomatous pyelonephritis. In general, the clinical presentation of these entities does not differentiate them; various radiographic studies can distinguish them, however. The intrarenal abscess is usually treated successfully with antibiotic therapy alone. Antistaphylococcal therapy is indicated for the renal cortical abscess, whereas therapy directed against the common gram-negative uropathogens is indicated for most of the other entities. The perinephric abscess is often an elusive diagnosis, has a more serious prognosis, and is more difficult to treat. Drainage of the abscess and sometimes partial or complete nephrectomy are required for resolution.
由于采用了更敏感的放射学技术，我们对肾脓肿谱系的认识有所增加。肾内脓肿的分类现在包括急性局灶性细菌性肾炎和急性多灶性细菌性肾炎，以及先前已认识到的肾皮质脓肿、肾皮质髓质脓肿和黄色肉芽肿性肾盂肾炎。一般来说，这些实体的临床表现并不能将它们区分开来；然而，各种影像学检查可以将它们区分开来。肾内脓肿通常仅用抗生素治疗就能成功治愈。肾皮质脓肿需要抗葡萄球菌治疗，而针对大多数其他实体则需要针对常见革兰氏阴性尿路病原体的治疗。肾周脓肿往往难以诊断，预后更严重，治疗也更困难。脓肿引流，有时还需要部分或全肾切除才能治愈。
