Successful Conservative Treatment of a Hepatic Abscess Originating from a Ruptured Renal Abscess in an Elderly Female

Summary 

A liver abscess originating from a ruptured renal abscess is a very rare clinical condition. In the past, the commonly recommended strategy for extrarenal abscess extension involved surgical management. For this case, mindful of the advanced age of patient, we had success in treating with parenteral antibiotics and computed tomography (CT)-guided drainage. An 86-year-old female presented to our emergency department with right flank pain for 1 month and high fever. A series of examinations were done, and xanthogranulomatous pyelonephritis with multiple abscess formation involving the liver and ruptured renal abscess was diagnosed. We successfully treated with CT-guided drainage, followed by parenteral antibiotic administration. She gradually recovered and was discharged 12 days after admission. To our knowledge, this is the first case of a liver abscess originating from a ruptured renal abscess and successful conservative treatment.

Key Words:  antibiotics , kidney stones , liver abscess , rupture , xanthogranulomatous pyelonephritis

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