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題名 | Course and Management of Renal Subcapsular Abscess in a 63-Year-Old Diabetic Woman=一位63歲糖尿病女性罹患腎臟包膜下膿瘍之病程與治療 |
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作者 | 余文良; 簡紹南; 蔣咸嘉; | 書刊名 | 臺灣醫學會雜誌 |
卷期 | 97:1 1998.01[民87.01] |
頁次 | 頁73-75 |
分類號 | 415.74 |
關鍵詞 | 糖尿病; 女性; 腎臟包膜下膿瘍; Renal subcapsular abscess; Percutaneous catheter drainage; Klebsiella pneumoniae; Enterobacter cloacae; |
語文 | 英文(English) |
英文摘要 | 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 perirenal abscesses. We describe a 63-year- old diabetic woman who presented with intermittent fever of 1 month's duration. She was initially treated for suspected acute pyelonephritis then referred to our hospital because of poor clinical response to cefazolin plus gentamicin. Computed tomography of the abdomen revealed a huge subcapsular abscess with displacement and compression of the left renal parenchyma. A percutaneous catheter was inserted and left in place for 8 days; a total of approximately 850 mL of pus was drained. Culture of the pus yielded Klebsiella pneumoniae and Enterobacter cloacae. A 2-week course of moxalactam was administered on the basis of the results of in vitro antibiotic susceptibility testing. The distorted renal parenchyma appeared normal at sonographic follow-up examination 3 weeks after hospitalization. The course and management of this rare entity are presented as a reminder to physicians that renal subcapsular 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. |
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