pISSN 2093-2340   eISSN 2092-6448
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    Infect Chemother. 2009 Sep-Oct;41(5):293-297. Korean.
    Published online Oct 31, 2009.
    https://doi.org/10.3947/ic.2009.41.5.293
    Copyright © 2009 The Korean Society of Infectious Diseases and The Korean Society for Chemotherapy
    Case Report

    Acute Pyelonephritis Complicated by Renal Vein Thrombosis and Pulmonary Embolism in Patient without any Thrombotic Risks

    Kwangsoo Lee, M.D.,1 Areum Kim, M.D.,1 Seung Youn Lee, M.D.,1 Ju Hong Jung, M.D.,1 Mijeong Kim, M.D., Ph.D.,1 Jin-Soo Lee, M.D., Ph.D.,1 Moon-Hyun Cheong, M.D., Ph.D.,1 Kee-chun Hong, M.D., Ph.D.,2 and Soon-Koo Cho, M.D., Ph.D.3
      • 1Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
      • 2Department of General Surgery, Inha University School of Medicine, Incheon, Korea.
      • 3Department of Radiology, Inha University School of Medicine, Incheon, Korea.
    • Corresponding author: Mijeong Kim, M.D., Ph.D. Department of Internal Medicine, Inha University School of Medicine, 7-206, 3-ga, Sinheung-dong, Jung-gu, Incheon, 400-711, Korea. Tel: +82-32-890-2202, Fax: +82-32-882-6578, Email: retitia@daum.net
    Received June 03, 2009; Accepted August 12, 2009.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Renal vein thrombosis (RVT) is not an uncommon condition amongst patients with nephrotic syndrome or malignancy. Septic pulmonary embolism (SPE) is associated with risk factors such as intravenous drug use, pelvic thrombophlebitis, and suppurative processes in the head and neck. However, acute pyelonephritis is a rare cause of RVT and SPE. Case reports on RVT and SPE due to acute pyelonephritis are rare. In most of the earlier cases, patients had underlying conditions such as diabetes mellitus, renal carcinoma, calyceal stones, and hyperhomocysteinemia. We report a case of acute pyelonephritis complicated by RVT and SPE that occurred in a patient without any predisposing risk factors for thromboembolism. RVT and SPE were diagnosed using computed tomography and ventilation/perfusion scan. The patient recovered with antibiotics and anticoagulation therapy without any surgical interventions.

    Keywords
    Pyelonephritis; Pulmonary embolism; Venous throbosis; Renal vein

    Figures

    Figure 1
    Chest x-ray shows small amount of pleural effusion and multiple nodular lesions in both lung fields (A). Abdominal CT shows low attenuated lesion in upper pole of right kidney (B lower arrow) and thrombosis in right renal vein (B upper arrow).

    Figure 2
    Ventilation-perfusion scan of the lung shows multiple nonsegmental perfusion defects.

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    MeSH Terms
    Anti-Bacterial Agents
    Diabetes Mellitus
    Head
    Humans
    Hyperhomocysteinemia
    Neck
    Nephrotic Syndrome
    Pulmonary Embolism
    Pyelonephritis
    Renal Veins
    Risk Factors
    Thromboembolism
    Thrombophlebitis
    Thrombosis
    Metrics
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