Reevaluation of Modern Antibacterial Agents Used for Perirenal Abscess

Diagnostic criteria, clinical course, and therapeutic results in cases of perirenal abscess were studied in 12 patients hospitalized with that diagnosis in the years 1937-1942. The data were compared with those from a similar group of 13 patients hospitalized in the years 1952-1958. The pattern of renal infections has changed in recent years. The later group of patients were older, were less acutely sick on admission, and had to be hospitalized longer. Their course was exemplified by that of a 52-year-old woman with a long history of calculi and other urologic troubles; these had culminated in marked fever and paralytic ileus after a retrograde pyelogram was taken, when contrast medium extravasated into a large perirenal cavity. Recovery followed incision and drainage of the perirenal abscess. The authors consider this the treatment of choice for perirenal abscess and conclude that antibacterial agents are ineffective in chronic parenchymal renal disease.