Long-term haemodialysis patient with an enlarged kidney

摘要

A 70-year-old anuric woman with diabetes on maintenance haemodialysis for 14 years was referred for evaluation of an enlarged left kidney. She reported general lassitude, weight loss and left flank pain for the past 4 weeks. A palpable mass along the left colic gutter with tenderness was noted. Laboratory studies showed white blood cell count 7600/mm~3, platelet 256 000/mm~3, and C-reactive protein 2.17 mg/dL. Blood cultures were negative. Findings of computed tomography (CT) scan of the abdomen (Fig. 1) and histological section from her left nephroureterectomy (Fig. 2) were consistent with xanthogranulomatous pyelonephritis (XP). Cultures from the resected phlegmon grew Proteus mirabilis. I.v. administration of ceftriaxone 2 g once daily for 3 weeks had achieved satisfactory resolution.