Giant Pyonephrosis Due to Urolithiasis and Diabetes: A Case Report

Abstract

Pyonephrosis results from upper urinary tract infection in combination with obstruction and hydronephrosis. The consequence of that is the suppurative destruction of the renal parenchyma. Instead of infection and obstruction which play a role in its etiology, some factors can be considered as risk for pyonephrosis, such as immunosuppression due to medications (steroids), disease (diabetes mellitus, acquired immunodeficiency syndrome [AIDS]). Patients with pyonephrosis may present clinical symptoms and signs such as fever, flank pain and nephromegaly. The diagnose is performed using imaging means (computed tomography, ultrasound). Without treatment, the disease can progress to the urosepsispyonephrosis, which is the most redoubtable complication. The chosen treatment for patients remains nephrostomy or nephrectomy. In some cases, partial nephrectomy may be an option. We are presenting a case of a diabetic patient who with a giant pyonephrosis.