[Perinephritic cellulitis. Apropos of 75 cases]

Abstract

In spite of the contribution of the new techniques of radiology and the use of new antibiotics, the diagnosis of perinephric abscess remains difficult and late and is at the origin of high morbidity and mortality. 75 cases of perinephric abscess collected during 15 years are reviewed. We studied the etiopathogenic, diagnostic, bacteriologic and therapeutic characteristics of this affection. Urinary signs are found in 26.7% of patients, diabetes in 17% and extra urinary origin is found in 11% of patients. Diagnostic delay is over one month in 75% of patients. Ultrasonography is carried out in 55 patients showing evocative images of perinephric abscess in 96% of cases. Computed tomography seems more performant than ultrasonography. Gram negative bacillus and staphylococcus are the germs which are the most frequently found. Surgical drainage associated to antibiotherapy is realized in all patients with collected perinephric abscess (73 cases). Evolution is often favourable in spite of the expanse of the abscedation. Literature data about pathogenesis, bacteriology, diagnosis and treatment of this affection are discussed.