Rinder M R
Department of Medicine, University of Maryland, Medical Center in Baltimore, USA.
Md Med J. 1996 Oct;45(10):839-43.
A patient had pyleonephritis with fever and pain that did not resolve, which prompted an abdominal ultrasound examination that showed an abscess within the renal cortex. Renal abscesses are particularly dangerous because of their location and potential spread to adjacent tissues. Although ultrasound is the best modality for imaging a renal abscess, computed tomography provides better tissue contrast, especially in obese patients. The pathophysiology of renal abscesses has changed during the past 25 years. Most cases are now caused by gram negative enteric organisms that are similarly pathogenic in uncomplicated cystitis and pyelonephritis. Successful treatment of a renal abscess requires long-term intravenous and oral antibiotics; surgical or percutaneous drainage is reserved for nonresponders.
一名患有肾盂肾炎的患者伴有发热和疼痛，症状持续未缓解，这促使其进行了腹部超声检查，结果显示肾皮质内有一个脓肿。肾脓肿因其位置以及可能扩散至邻近组织而特别危险。尽管超声是对肾脓肿进行成像的最佳方式，但计算机断层扫描能提供更好的组织对比度，尤其是在肥胖患者中。在过去25年里，肾脓肿的病理生理学发生了变化。现在大多数病例是由革兰氏阴性肠道菌引起的，这些细菌在单纯性膀胱炎和肾盂肾炎中具有相似的致病性。成功治疗肾脓肿需要长期静脉和口服抗生素；对于无反应者则采用手术或经皮引流。
