Diabetes Monit 2001;2(2):168-173.
고령의 제 2 형 당뇨병 환자에서 발생한 신장 피막하 농양 1 예
권계형, 김충현, 김성훈, 신원용, 엄중호, 윤진훈, 정인수, 김병준, 안규정
A Case of Renal Subcapsular Abscess in a Old age Diabetic Patient
Kye Hyoung Kwon, Chung Hyeon Kim, Sung Hoon Kim, Won Yong Shin, Jung Ho Eum, Jin Hoon Yun, In Su Jung, Byung Joon Kim, Kyu Jung Ahn
Abstract
Renal subcapsular abscess is a very rare disease that is defined by a suppurative process localized to a space between the renal capsule and the renal parenchyma. The course and management of subcapsular abscesses have received less attention than those of renal and perlrenal abscesses. We describe a 89-year-old diabetic woman who presented with continuous fever for several days. We initially treated her for urinary tract infection like acute pyelonephritis with secondary generation cephalosporine plus aminoglycoside then recognized abscess formation by ultrasonography. Computed tomography of the abdomen revealed a huge subcapsular abscess. A percutaneous catheter was inserted and left in place for 17 days. Both culture of the pus and urine yielded Klebsiella pneumoniae which was sensitive to used antibiotics. These drugs was administered for 30 days. We changed to Ⅳ antibiotics with oral agent and maintained for 12days. The cystic lesion was disappeared at sonographic follow-up examination. The course and management of this rare disease are presented as a reminder to physicians that renal sucapsular abscess could manifest as fever of unknown origin in a diabetic patient. A high degree of clinical suspicion is required for early diagnosis and treatment in order to achieve a satisfactory outcome.
Key Words: Subcapsular abscess , Percutaneous catheter drainage


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