Abstract：
BACKGROUND: In the emergency department (ED), pyelonephritis is a fairly common diagnosis, especially in patients with unilateral flank pain. Xanthogranulomatous pyelonephritis (XGP) is a rare type of pyelonephritis that is associated with unique features, which may lead to its diagnosis.
METHODS: A 30-year-old male patient presented to the ED for evaluation of right-sided abdominal pain that has been ongoing for the past 24 hours. He noted the pain was located predominantly in the right flank and described it as sharp in nature. The pain was nonradiating and was associated with scant hematuria. He stated that he had similar pains approximately 1 month earlier that resolved after a few days. The patient underwent a bedside ultrasound and a subsequent computed tomography (CT) scan of the abdomen and pelvis, which showed an enlarged, multiloculated right kidney with dilated calyces and a large staghorn calculus, findings that represent XGP. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report highlights an unusual variant of pyelonephritis, a relatively common ED diagnosis. XGP should be considered in patients with recurrent pyelonephritis, as treatment for XGP may require surgical intervention in addition to traditional antibiotic management.
METHODS: A 30-year-old male patient presented to the ED for evaluation of right-sided abdominal pain that has been ongoing for the past 24 hours. He noted the pain was located predominantly in the right flank and described it as sharp in nature. The pain was nonradiating and was associated with scant hematuria. He stated that he had similar pains approximately 1 month earlier that resolved after a few days. The patient underwent a bedside ultrasound and a subsequent computed tomography (CT) scan of the abdomen and pelvis, which showed an enlarged, multiloculated right kidney with dilated calyces and a large staghorn calculus, findings that represent XGP. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report highlights an unusual variant of pyelonephritis, a relatively common ED diagnosis. XGP should be considered in patients with recurrent pyelonephritis, as treatment for XGP may require surgical intervention in addition to traditional antibiotic management.
摘要：
背景：在急诊科（ED），肾盂肾炎是一种相当常见的诊断，尤其是单侧侧腹疼痛患者。黄色肉芽肿性肾盂肾炎（XGP）是一种罕见的肾盂肾炎，具有独特的特征，这可能导致其诊断。
方法：一名30岁男性患者就诊于ED，以评估过去24小时内持续的右侧腹痛。他指出疼痛主要位于右侧，并将其描述为剧烈的疼痛。疼痛是非放射性的，并伴有少量血尿。他说，大约一个月前，他有类似的痛苦，几天后就解决了。患者接受了床旁超声检查，随后进行了腹部和骨盆的计算机断层扫描（CT）扫描，显示了一个放大的，多部位右肾有扩张的肾盏和大的鹿角状结石，代表XGP的发现。为什么紧急医生应该意识到这一点？：这个病例报告突出了肾盂肾炎的一个不寻常的变种，相对常见的ED诊断。复发性肾盂肾炎患者应考虑XGP，因为XGP的治疗除了传统的抗生素治疗外，还可能需要手术干预。
方法：一名30岁男性患者就诊于ED，以评估过去24小时内持续的右侧腹痛。他指出疼痛主要位于右侧，并将其描述为剧烈的疼痛。疼痛是非放射性的，并伴有少量血尿。他说，大约一个月前，他有类似的痛苦，几天后就解决了。患者接受了床旁超声检查，随后进行了腹部和骨盆的计算机断层扫描（CT）扫描，显示了一个放大的，多部位右肾有扩张的肾盏和大的鹿角状结石，代表XGP的发现。为什么紧急医生应该意识到这一点？：这个病例报告突出了肾盂肾炎的一个不寻常的变种，相对常见的ED诊断。复发性肾盂肾炎患者应考虑XGP，因为XGP的治疗除了传统的抗生素治疗外，还可能需要手术干预。
