“ Usually due to Escherichia coli ascending the urinary tract . Most common in women aged less than 40 years and men aged >65 years . I...
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Usually due to Escherichia coli ascending the urinary tract. Most common in women aged less than 40 years and men aged >65 years. Imaging only if no response to treatment or severely unwell in order to assess for abscess.
CT
• Best clue is wedge-shaped areas of hypoattenuation that extend to the renal capsule (i.e. oedema) on the excretory phase post-contrast, ‘striated nephrogram’
US
• Non-specific, most commonly diffusely hypoechoic appearance with loss of corticomedullary differentiation.
• Kidney may be enlarged.
Post-contrast axial computed tomography scan of a patient presenting with sepsis and right loin pain. The right kidney is enlarged and contains streaks of low density (white arrow) extending to the renal cortex, the so-called ‘striated nephrogram’. This appearance is characteristic of acute pyelonephritis
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