Clinical characteristics, etiology, and treatment strategies for renal and perinephric abscesses in adults: a single-center, descriptive, 10-year retrospective analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: This study aimed to investigate the clinical characteristics, etiology, and antimicrobial resistance patterns of renal abscesses (RAs) and perinephric abscesses (PNAs) in adults and to analyze the associated treatment outcomes. A retrospective analysis was conducted on 40 adults who were diagnosed with RAs or PNAs at our institution between October 2014 and December 2024. The data collected included demographics, risk factors, clinical presentations, laboratory/imaging findings, microbiology, treatment modalities, and outcomes. The median age of the patients was 51 years (IQR: 38–63 years; range, 18–84 years), with a male-to-female ratio of 1:2.1. Diabetes mellitus (50%) and urinary tract calculi (35%) were the most common risk factors. The predominant clinical manifestations included fever (72.5%), chills (37.5%), and flank pain (35%). Laboratory findings frequently revealed leukocytosis (87.5%), markedly elevated C-reactive protein (CRP) (median, 174 mg/L; IQR: 124.5-214.5 mg/L), and elevated procalcitonin (67.5%). Escherichia coli (E. coli) was the predominant pathogen, identified in 28 out of 39 positive cultures (71.8%), with a high proportion (53.57%) being extended-spectrum β-lactamase (ESBL) producers.Contrast-enhanced computed tomography (CT) was the most frequently used and clinically most useful diagnostic tool, establishing or strongly supporting the diagnosis in 62.5% of patients. Treatment included antibiotics alone (55%), antibiotics combined with drainage (42.5%), and nephrectomy (2.5%). All patients showed clinical improvement at discharge after a median hospital stay of 12 days (IQR: 8–16 days). During follow-up among the 30 patients who had regular outpatient visits, 83.33% (25/30) experienced resolved infections, whereas 16.67% (5/30) experienced recurrence. The outcomes for the remaining 10 patients who did not complete regular follow-up were not captured. RAs and PNAs often present with nonspecific symptoms, underscoring the importance of early diagnosis and management. Diabetes is a major risk factor, and infections are predominantly caused by highly resistant E. coli. Contrast-enhanced CT is essential for diagnosis, but combination antibiotic and drainage therapy effectively improves patient prognosis. Optimizing antibiotic selection and intervention timing should be future priorities. Not applicable.
Source: BMC Infectious Diseases
Authors: Yali Liu, Yu Zhang, Yongxiang Li, Jie Yang
Institution: Zhejiang University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W7203861313
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