Perinephric and intranephric abscesses: a review of the literature.

Perinephric and intranephric (renal cortical and corticomedullary) abscesses, which may coexist, are associated with considerable mortality (21 percent to 56 percent) and are often difficult to diagnose. Most cases of renal cortical abscess are due to hematogenous seeding from distant foci of infection (often involving Staphylococcus aureus), while corticomedullary and perinephric abscesses are most often due to complications of urinary tract infections. Newer noninvasive studies such as ultrasonography, computerized tomography, gallium scanning and indium-labeled leukocyte scanning may facilitate determination of the diagnosis. While antibiotic therapy alone may suffice for the treatment of cortical abscesses, surgical drainage is an added requirement for the treatment of perinephric abscess.