Xanthogranulomatous Pyelonephritis with Pyonephrosis and Renal Abscess in a Young Adult: A Consequence of Neglected Urinary Tract Infection Leading to Nephrectomy
Xanthogranulomatous pyelonephritis (XGP) is a rare form of chronic pyelonephritis, which is challenging to diagnose because its clinical presentation mimics other entities and is commonly associated with a history of urinary tract obstruction. We report a case of XGP in a young adult without nephrol...
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Interna Publishing
2022-01-01
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| Series: | Acta Medica Indonesiana |
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| Online Access: | http://www.actamedindones.org/index.php/ijim/article/view/1443 |
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| author | Ali Ariyono Maria F Pudjohartono Thomas Rikl Hanggoro Tri Rinonce Hadi Irawiraman Yulita Pundewi Setyorini Daisy Tumedia |
| author_facet | Ali Ariyono Maria F Pudjohartono Thomas Rikl Hanggoro Tri Rinonce Hadi Irawiraman Yulita Pundewi Setyorini Daisy Tumedia |
| author_sort | Ali Ariyono |
| collection | DOAJ |
| description | Xanthogranulomatous pyelonephritis (XGP) is a rare form of chronic pyelonephritis, which is challenging to diagnose because its clinical presentation mimics other entities and is commonly associated with a history of urinary tract obstruction. We report a case of XGP in a young adult without nephrolithiasis and urinary tract obstruction. A 23-year-old woman presented with intermittent abdominal pain in the right upper quadrant persisting for the last ten months. The pain was dull, poorly localized, and started spreading to the right back, right shoulder, and right thigh in the last three months. Other complaints included fever, chills, pain during urination, and nausea. The patient had a history of infrequent urination, recurrent urinary tract infections (UTIs), and a low fluid intake. A physical examination revealed that the patient had right upper quadrant abdominal tenderness and right costovertebral angle tenderness. Laboratory findings showed leukocytosis and neutrophilia. The radiological examination revealed a round mass in the superior pole of the right kidney with mixed cystic and solid components, and a well-defined margin. It further enlarged from 4.5 cm to 10.6 cm in diameter in three months. The urologist performed a total right nephrectomy. The histopathological examination showed XGP with renal abscess. Proteus mirabilis was identified from the pus specimen culture. XGP should be considered in the diagnosis of patients having chronic UTI presented with or without the findings of urinary tract obstruction. |
| format | Article |
| id | doaj-art-522e2b9fe4ca4604aaba0e8f5c2555c9 |
| institution | OA Journals |
| issn | 0125-9326 2338-2732 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Interna Publishing |
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| series | Acta Medica Indonesiana |
| spelling | doaj-art-522e2b9fe4ca4604aaba0e8f5c2555c92025-08-20T02:37:14ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322022-01-01534Xanthogranulomatous Pyelonephritis with Pyonephrosis and Renal Abscess in a Young Adult: A Consequence of Neglected Urinary Tract Infection Leading to NephrectomyAli Ariyono0Maria F Pudjohartono1Thomas Rikl2Hanggoro Tri Rinonce3Hadi Irawiraman4Yulita Pundewi Setyorini5Daisy Tumedia6Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia.Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia.Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia.Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia.Department of Anatomical Pathology, Faculty of Medicine, Mulawarman University, Samarinda, IndonesiaDepartment of Anatomical Pathology, Dr. Kanujoso Djatiwibowo Hospital, Balikpapan, IndonesiaDepartment of Anatomical Pathology, Dr. Kanudjoso Djatiwibowo Hospital, Balikpapan, IndonesiaXanthogranulomatous pyelonephritis (XGP) is a rare form of chronic pyelonephritis, which is challenging to diagnose because its clinical presentation mimics other entities and is commonly associated with a history of urinary tract obstruction. We report a case of XGP in a young adult without nephrolithiasis and urinary tract obstruction. A 23-year-old woman presented with intermittent abdominal pain in the right upper quadrant persisting for the last ten months. The pain was dull, poorly localized, and started spreading to the right back, right shoulder, and right thigh in the last three months. Other complaints included fever, chills, pain during urination, and nausea. The patient had a history of infrequent urination, recurrent urinary tract infections (UTIs), and a low fluid intake. A physical examination revealed that the patient had right upper quadrant abdominal tenderness and right costovertebral angle tenderness. Laboratory findings showed leukocytosis and neutrophilia. The radiological examination revealed a round mass in the superior pole of the right kidney with mixed cystic and solid components, and a well-defined margin. It further enlarged from 4.5 cm to 10.6 cm in diameter in three months. The urologist performed a total right nephrectomy. The histopathological examination showed XGP with renal abscess. Proteus mirabilis was identified from the pus specimen culture. XGP should be considered in the diagnosis of patients having chronic UTI presented with or without the findings of urinary tract obstruction.http://www.actamedindones.org/index.php/ijim/article/view/1443Xanthogranulomatous pyelonephritispyonephrosisrenal abscessProteus mirabilisnephrectomy |
| spellingShingle | Ali Ariyono Maria F Pudjohartono Thomas Rikl Hanggoro Tri Rinonce Hadi Irawiraman Yulita Pundewi Setyorini Daisy Tumedia Xanthogranulomatous Pyelonephritis with Pyonephrosis and Renal Abscess in a Young Adult: A Consequence of Neglected Urinary Tract Infection Leading to Nephrectomy Acta Medica Indonesiana Xanthogranulomatous pyelonephritis pyonephrosis renal abscess Proteus mirabilis nephrectomy |
| title | Xanthogranulomatous Pyelonephritis with Pyonephrosis and Renal Abscess in a Young Adult: A Consequence of Neglected Urinary Tract Infection Leading to Nephrectomy |
| title_full | Xanthogranulomatous Pyelonephritis with Pyonephrosis and Renal Abscess in a Young Adult: A Consequence of Neglected Urinary Tract Infection Leading to Nephrectomy |
| title_fullStr | Xanthogranulomatous Pyelonephritis with Pyonephrosis and Renal Abscess in a Young Adult: A Consequence of Neglected Urinary Tract Infection Leading to Nephrectomy |
| title_full_unstemmed | Xanthogranulomatous Pyelonephritis with Pyonephrosis and Renal Abscess in a Young Adult: A Consequence of Neglected Urinary Tract Infection Leading to Nephrectomy |
| title_short | Xanthogranulomatous Pyelonephritis with Pyonephrosis and Renal Abscess in a Young Adult: A Consequence of Neglected Urinary Tract Infection Leading to Nephrectomy |
| title_sort | xanthogranulomatous pyelonephritis with pyonephrosis and renal abscess in a young adult a consequence of neglected urinary tract infection leading to nephrectomy |
| topic | Xanthogranulomatous pyelonephritis pyonephrosis renal abscess Proteus mirabilis nephrectomy |
| url | http://www.actamedindones.org/index.php/ijim/article/view/1443 |
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