Critical Care Medicine-Infections and Immunologic Disease>>>>>Genitourinary Infection
Question 4#

What diagnostic test is MOST appropriate to evaluate for perinephric abscess?

A. Abdominal ultrasound
B. Computed tomography (CT) of the abdomen and pelvis
C. Magnetic resonance imaging (MRI) of the abdomen and pelvis
D. All of the above are appropriate depending on the clinical situation

Correct Answer is D

Comment:

Correct Answer: D

The diagnosis of perinephric or renal abscess should be confirmed by imaging. The most commonly used imaging modality is CT scan (Answer B), which has the added advantage of diagnosing extension of infection to adjacent structures, which is more difficult to see on ultrasound imaging (Answer A). MRI (Answer C) is highly sensitive for detecting changes in the urinary tract, but is generally less accessible than CT or ultrasound imaging, and is the least often used. Choice of imaging modality to confirm the diagnosis of renal or perinephric abscess should be tailored to the individual patient and their clinical situation.

References:

1. Demertzis J, Menias CO. State of the art: imaging of renal infections. Emerg Radiol. 2007;14(1):13. Epub 2007 Feb 21.
2. Rubilotta E, Balzarro M, Lacola V, Sarti A, Porcaro AB, Artibani W. Current clinical management of renal and perinephric abscesses: a literature review. Urologia. 2014;81(3):144-147.