Infect Chemother.  2009 Oct;41(5):293-297. 10.3947/ic.2009.41.5.293.

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

• Lee K
• Kim A
• Lee SY
• Jung JH
• Kim M
• Lee JS
• Cheong MH
• Hong KC
• Cho SK

• KMID: 1473656
• DOI: http://doi.org/10.3947/ic.2009.41.5.293

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.

Keyword

Pyelonephritis; Pulmonary embolism; Venous throbosis; Renal vein

MeSH Terms

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

Figure

• 

  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).

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

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