A Case of Huge Infected Adrenal Pseudocyst associated with Acute Pyelonephritis and E. coli Bacteremia

Korean Journal of Nephrology 2007;26(3):364-367.

Eun Hui Bae, M.D., Soo Wan Kim, M.D. Nam Ho Kim, M.D. and Ki Chul Choi M.D.

Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea

A Case of Huge Infected Adrenal Pseudocyst associated with Acute Pyelonephritis and E. coli Bacteremia

Eun Hui Bae, M.D., Soo Wan Kim, M.D. Nam Ho Kim, M.D. and Ki Chul Choi M.D.

Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea

Abstract

A 61-year-old woman was presented with fever and pain in both flanks. Computed tomography (CT) revealed a septated heterogenous giant mass suggesting a huge suprarenal cyst. Percutaneous drainage was performed. Escherichia coli was cultured in blood, urine and aspirated fluid from the cyst. Therefore, it was initially diagnosed as infected renal cyst with acute pyelonephritis. However, follow-up CT after drainage of the cyst and surgical findings revealed the cyst grew not from the kidney but from the adrenal gland. Postoperative finding and pathologic study confirmed it was originated from adrenal. We describe a case of E.coli infected huge adrenal pseudocyst misunderstood as an infected renal cyst because of indistinct anatomical boundary and association with acute pyelonephritis.

Key Words: Adrenal gland, Infection, Pyelonephritis