NEW - Pathology Corner by Prof. Franco Ferrario

Brand new high fidelity nephropathology section -> the OLA Pathology Corner

  • cases hand-picked by Professor Franco Ferrario
  • high-fidelity dedicated viewing software
  • discussion and tutoring via OLA forum
  • free to registered users -> sign up now

Question: October 2016

 
(19 Votes)
<< Back to questions overview

A 49 -year-old man,  who is under the care of the nephrology clinic as he has CKD due to autosomal dominant polycystic kidney disease admitted to the nephrology ward being unwell. He has a 3 day history of left loin pain, mild nausea, and fever. On physical examination, the patient looks ill. Temperature is 39 °C , blood pressure is 130/85 mm Hg, pulse rate is 110 bpm, and respiratory rate is 22/min. Chest is clear and heart sounds are normal. Abdomen is soft but with left costovertebral angle tenderness and bowel sounds are audible.

Laboratory results :

HB                          135 g/l

WCC                       15,000 X109 /l

S. creatinine             2.1 mg/dl (186 mmol/l)

Urine Dipstick           Negative

Negative urine culture.

Ultrasound KUB : the left kidney is 16.7 cm, and the right kidney is 16.9 cm; multiple bilateral intraparenchymal cysts are noted consistent with polycystic disease.

 

What is the most likely diagnosis?

Cyst haemorrhage
Cyst infection
Muscular abcess above at left renal angle
Perinephric abcess
Left Basal Pneumonia
Page 1 of 3