Abstract
Obstructive pyelonephritis is a urological emergency that may progress to severe sepsis if urinary drainage is not rapidly achieved. Hematogenous dissemination leading to metastatic soft tissue abscesses remains ex ceptional. We report the case of a 76-year-old woman admitted with febrile flank pain and general deteriora tion. CT urography revealed an 8 mm obstructive stone of the right lumbar ureter responsible for obstructive pyelonephritis. Emergency drainage was performed with placement of a double J ureteral stent. Four days later, an inflammatory swelling appeared on the left leg. Soft tissue CT demonstrated a deep collection con sistent with an abscess requiring surgical drainage. Cultures from the pyelic urine and the abscess grew the same organism: Escherichia coli. The outcome was favorable after appropriate antibiotic therapy.
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