Journal of Preventive Medicine & Infectious Diseases

Abstract

Obstructive pyelonephritis is a urological emergency that may progress to severe sepsis if urinary drainage is not rapidly achieved. Hematogenous dissemination leading to metastatic soft tissue abscesses remains exceptional. We report the case of a 76-year-old woman admitted with febrile flank pain and general deterioration. CT urography revealed an 8 mm obstructive stone of the right lumbar ureter responsible for obstructive pyelonephritis. Emergency drainage was performed with placement of a double J ureteral stent. Four days later, an inflammatory swelling appeared on the left leg. Soft tissue CT demonstrated a deep collection consistent with an abscess requiring surgical drainage. Cultures from the pyelic urine and the abscess grew the same organism: Escherichia coli. The outcome was favorable after appropriate antibiotic therapy.