case_images: PMC11249474_01
case_images: Renal ultrasound at the first ED visit. a Left kidney - anechoic area in the renal pelvis. b Right kidney is unremarkable.
case_images: cnd-2024-0014-0001-539390_F01.jpg
case_images: PMC11249474_01_cnd-2024-0014-0001-539390_F01.jpg
case_images: F1
case_images: The patient was examined by a urologist upon ultrasonography without absolute evidence of obstruction (Fig. 1), and antibiotic therapy with cefixime was started in the outpatient setting after the patient refused hospital admission.
case_images: Renal ultrasound on the left kidney at the second ED visit. Kidney was enlarged but otherwise unremarkable.
case_images: cnd-2024-0014-0001-539390_F02.jpg
case_images: PMC11249474_01_cnd-2024-0014-0001-539390_F02.jpg
case_images: F2
case_images: Laboratory tests revealed Hb 150 g/L, WBC 10.5 G/L, PLT 104 G/L, CRP 466 mg/L, procalcitonin 163 ng/mL, serum creatinine 661 mumol/L, urea 36.1 mmol/L, potassium 6.4 mmol/L, AST 287 U/L, albumin 31 g/L, sodium 139 mmol/L, blood sugar, and HbA1c within normal range, with no evidence of obstructed drainage (Fig. 2).
case_images: Renal ultrasound on the left kidney at the time of the CT scan. Left kidney shows enlargement. Increased anechoic area in the renal pelvis.
case_images: cnd-2024-0014-0001-539390_F03.jpg
case_images: PMC11249474_01_cnd-2024-0014-0001-539390_F03.jpg
case_images: F3
case_images: An increased anechoic area in the renal pelvis was observed (Fig. 3).
case_images: CT image of the patient. The asterisk marks gas collections in the left kidney.
case_images: cnd-2024-0014-0001-539390_F04.jpg
case_images: PMC11249474_01_cnd-2024-0014-0001-539390_F04.jpg
case_images: F4
case_images: A computer tomography (CT) scan of the abdomen and pelvis revealed left-sided pyelonephritis with air collections in the renal collecting system and moderately dilated renal pelvis, without evidence of obstruction, with inflammatory changes in the left perinephric fat tissue (Fig. 4).