臨床症状に乏しかった後腹膜膿瘍

Retroperitoneal abscess deficient in clinical symptoms：A case report

症例は63歳，男性。全身倦怠感，食欲不振を主訴に当院腎臓内科を受診。典型的な臨床症状に乏しく，当初腎盂腎炎として治療していたが改善を認めず，腹部CTを施行したところ右後腹膜膿瘍が判明した。経皮的ドレナージ術を施行し，著明な全身状態の改善がみられた。当症例は糖尿病，慢性腎不全，神経因性膀胱という易感染性が背景に存在し，腎盂腎炎より後腹膜膿瘍へ移行したと考えられた。

A 63-year-old man with diabetes mellitus,renal failure and neurogenic bladder was hospitalized complaing of general fatigue and a poor appetite. In the beginning,he was diagnosed as pyelonephritis therefore was treated with antibiotics,which however was ineffective. For further examinations,we carried out abdominal computed tomography,which revealed a retoroperitoneal abscess posterior to the right kidney. Percutaneous drainage was then performed,and inflammatory symptoms improved. The abscess fluid culture proved to be MRSA. We believe the patient,with these dangerous factors easily involved to infectious disease,developed retroperitoneal abscess following chronic pyelonephritis.