*48-years-old female with flank pain and fever.
What is the most likely diagnosis?
Answer
Answer: Periportal edema associated with severe acute pyelonephritis.
Case Discussion:
Periportal edema and ascites are nonspecific radiologic findings representing accumulation of fluid within third spaces. A multifactorial etiology for periportal edema in acute infectious disease has been suggested, including altered sodium reabsorption as a result of the infectious process involving the renal interstitium and increased vascular permeability secondary to systemic sepsis or hypoalbuminemia.
References:
1. Zissin R, Osadchy A, Gayer G, Kitay-Cohen Y. Extrarenal manifestations of severe acute pyelonephritis: CT findings in 21 cases. Emerg Radiol. 2006;13:73–77.
2. Zissin R, Kots E, Rachmani R, Hadari R, Shapiro-Feinberg M. Hepatic periportal tracking associated with severe acute pyelonephritis. Abdom Imaging. 2000;25:251–254.