Staghorn Calculus and Xanthogranulomatous Pyelonephritis Complicated
by Inflammation of the Vena Cava.
A 30-year-old female with multiple presentations for pyelonephritis
was diagnosed with Xanthogranulomatous pyelonephritis by computed tomography scan.
intermittently symptomatic for 8-years with numerous healthcare
encounters without the correct diagnosis.
The patient was treated recurrently for pyelonephritis with transient
clearing of her symptoms without diagnostic imaging.
The prolonged nature of her disease likely resulted
in a complicated surgical course with inflammation of her liver and inferior vena cava
The disease affects both adults and children, has a female predominance
and is usually unilateral.
An obstructive process and bacterial infection
are contributing factors.
Treatment consists of temporization with antibiotics
and nephrectomy.
Pathology showed a 10 by 6-centimetre kidney with “multiple cystic spaces
filled with yellow pus-like fluid, with tan-white chalky stones with histology
showing a final diagnosis of Xanthogranulomatous pyelonephritis.
Patient recovered well and continued follow-up with urology with yearly
ultrasounds to her remaining kidney to assess for development of further
nephrolithiasis Xanthogranulomatous pyelonephritis is a rare but significant
urological disease with significant risk for complications and morbidity and may be
preventable with early detection of patients at risk for complicated pyelonephritis.
non-XGP chronic pyelonephritis and renal tuberculosis. Untreated may lead
to invasive spread, fistula formation, and systemic infection. Nephrectomy i
s the definitive treatment and the
definitive diagnosis is made on histological examination.
Emerg Med Open J. 2017; 3(2): 66-68. doi: 10.17140/EMOJ-3-145