renal abscess by waheed

renal abcess

1. Adult Health Nursing

2. objectives Define renal abscess E tiology Factors of renal abscess Discuss the clinical features Investigation Diagnosis T reatment of renal abscess Ultrasound Complication of renal abscess Infection of renal abscess

3. 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.

4. Etiology : Staphylococcus aurous :release from distance sources Injury to the kidney E.coil (Escherichia coli)

5. Pathology of renal abscess G lomerular diseases Acute pyelonephritis Vascular disease Acute tubular necrosis Kidney stones (Urolithiasis) End stage renal disease Cancer

6. 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….

7. Risk factor of renal abscess Diabetes Mellitus Pregnancy Elderly Patients – 65 years and over Sickle Cell Disease Autoimmune Disease

8. Clinical features Symptoms: Fever, chills, loin pain Weight loss Excessive Sweating Abdominal pain Hypotension Bloody Urine Signs: Extreme tenderness over the affected kidney.

9. 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.

10. 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.

11. 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

12. Treatment Antibiotics Oral Intravenous Nephrectomy Hypertension Ace inhibitors 14

13. cont. Diabetes Metformin Insulin Percutaneous Drainage Abscess is a drained from outside and catheter is left for continuous drain and daily injection of antibiotics .

14. Ultrasound

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

16. infection Appendicitis Inflammation of the vermiform appendix Diverticulitis Inflammation of a diverticulum in the digestive tract Perinephric Abscess Renal Abscess

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