Persistent fever in a patient with Wunderlich syndrome

3^rd Global Experts Meeting on Medical Case Reports

May 09-10, 2016 New Orleans, USA

Marijeta Pekez

Crozer Chester Medical Center, USA

Posters & Accepted Abstracts: J Clin Case Rep

Abstract :

Wunderlich syndrome is spontaneous, non-traumatic renal hemorrhage confined to the sub-capsular and perirenal space. We present a case of a patient with a Wunderlich syndrome complicated by renal abscess. Patient was a 43 year old male who presented with nausea and generalized weakness, found to have sepsis secondary to urinary source. Ultrasound obtained during work up showed an old right perinephric hematoma. Patient continued to be febrile despite IV antibiotics. Repeat imaging with CT scan showed large abscess in place of the previously described sub-capsular hematoma. Successful CT-guided drainage of the abscess led to marked improvement and resolution of fever. Wunderlich syndrome is secondary to neoplastic and non-neoplastic causes. It usually presents as mild flank pain, flank tenderness or hematuria. Depending on blood loss, symptoms, of hypovolemic shock may develop. Treatment varies according to severity ranging from monitoring of the hematoma to nephrectomy. Our case is interesting since Wunderlich syndrome provided a nidus for infection and eventual abscess formation causing persistent fevers and flank pain with preserved hemodynamic stability. It demonstrated the need for CT imaging in order to fully appreciate the extent of the hemorrhage which in this case converted into an abscess. In the right clinical scenario, Wunderlich syndrome should be evaluated as a possible factor in infectious presentations.

Biography :

Email: pekez.marijeta@gmail.com