Abstract
A 32-year-old woman had a fever of approximately 39°C and left flank pain. Abdominal CT revealed marked hydronephrosis of the left kidney, and left percutaneous nephrostomy was performed.
Approximately 1, 000ml of pus was drained, low blood pressure, oliguria, and lung edema were later noted, and the patient was transferred to our hospital for general management and hemodialysis. A chest X-ray on admission showed severe congestion. We made a diagnosis of bacteremia associated with acute renal failure caused by puncture drainage for pyonephrosis following detection of Escherichia coli from both drainage urine cultures and blood cultures.
Disseminated intravascular coagulation (DIC) also developed. Hemodialysis was performed ten times starting on the day of admission. Conservative therapy (for example, platelet transfusion and antibiotics), however, was successful in allowing recovery from this deterioration.