Infection surrounding the kidney(s).

Causes, incidence, and risk factors

More than 75% of perirenal abscesses are caused by urinary tract infections that start in the bladder, spread to the kidney, and then to the area surrounding the kidney. Other causes of perirenal abscess include urological surgery and bloodstream infection. Approximately 0.02% of all hospital admissions have perirenal abscess. The most significant risk factor for perirenal abscess is the presence of kidney stones that block urinary flow and which serve as a reservoir for infection, because bacteria tend to stick to the stone and antibiotics can't kill the bacteria. Stones are found in 20-60% of patients with perirenal abscess. Other risk factors for perirenal abscess include having an abnormal urinary tract, having had surgery on the urinary tract, trauma, and having diabetes.

Signs and tests

Signs of perirenal abscess include tenderness in the back or abdomen. A urinalysis will show white cells and may also have red cells. A urine culture, if taken before antibiotics are given, may show one or more types of bacteria. Even if the urine culture is negative, white cells in the urine and a fever may indicate the presence of a perirenal abscess. A CT scan or ultrasound of the abdomen may show an inflamed kidney area, which would suggest a perirenal abscess.

Treatment

Treatment of a perirenal abscess includes drainage of the pus, either from a catheter placed through the skin, or via surgery. Antibiotics should also be given, initially by vein (IV).

Expectations (prognosis)

In general, prompt diagnosis and treatment of perirenal abscess should lead to a good outcome. If present, kidney stones must be treated to avoid further infections.

Complications

Complications of perirenal abscess include a continuing infection if kidney stones are present. Infection can spread into the area around the kidney and into the bloodstream, which could be deadly.

Calling your health care provider

You should call your health care provider if you have a history of kidney stones and develop a fever, chills, burning with urination, or abdominal pain.

Prevention

If you have kidney stones, ask your doctor about the best way to treat them and avoid a perirenal abscess. If you undergo urologic surgery, keep the surgical area as clean as possible.