Accessibility Tools

Skip to main content

You must be a logged-in member of UHMS or a subscriber to the UHMS Journal in order to download the articles listed within these pages. If you are a member or subscriber, please log in using the Log In button above. If you would like to purchase a membership or a subscription, use the buttons below.

Join the UHMS
Purchase a Subscription

Search UHM/UBR

Successful management of renal abscess secondary to diabetes mellitus with surgical treatment and hyperbaric oxygen therapy

Successful management of renal abscess secondary to diabetes mellitus with surgical treatment and hyperbaric oxygen therapy

HYPERBARIC OXYGEN THERAPY FOR RENAL ABSCESS SECONDARY TO DIABETES MELLITUS

Kazuki Yanagida, MD 1,2; Daisuke Watanabe, MD, PhD 1,3; Takahiro Yoshida, MD 1,2; Tohru Nakagawa, MD, PhD 2; Akio Mizushima, MD, PhD 3; Kunihisa Miura, MD, Ph D 4; Tohru Ishihara, MD, PhD 4

1 Department of Urology, Koto Hospital, Koto-ku, Tokyo, Japan

2 Department of Urology, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan

3 Department of Palliative Medicine, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan

4 Department of Emergency Medicine, Tokyo Hikifune Hospital, Sumida-ku, Tokyo, Japan

 

ABSTRACT

Renal abscess (RA) is a collection of infective fluid in or around the renal parenchyma. It typically occurs in immunocompromised patients, including those with diabetes mellitus (DM), poor nutritional status, or steroid administration. We herein report a case of RA associated with DM in which hyperbaric oxygen (HBO2) therapy greatly contributed to the resolution of this disease. The patient was an 85-year-old man with poorly controlled type 2 DM. Contrast-enhanced computed tomography for postoperative follow-up of appendiceal cancer showed a mass lesion with poor contrast enhancement extending from the upper pole of the left kidney to the dorsal side. Therefore, a diagnosis of RA was established. The lesion was percutaneously punctured, and a drainage tube was placed. Antibiotics following sensitivity testing were administered. The catheter was removed six days after its placement. However, pus discharge continued from the catheter removal site, with persistent redness around the wound. Therefore, a lumbotomy incision for abscess drainage was performed on the 49th day. However, the pus discharge persisted, and we decided to perform HBO2 therapy, expecting decreases in bacterial proliferation, reduction in local edema, and improvement of host defense. HBO2 therapy for 90 min at two atmospheres absolute was performed ten times. The amount of pus discharge decreased, and redness improved from the fifth day after HBO2 therapy. One month after starting HBO2 therapy, the wound was closed, and the pus discharge resolved completely. Four years have passed since the HBO2 therapy, and there have been no symptomatic or imaging relapses of RA.

Key words: hyperbaric oxygen therapy; renal abscess; SGLT2 inhibitor; type 2 diabetes mellitus

Key points: 

This report describes a case of renal abscess associated with poorly controlled diabetes mellitus that could not be cured with surgical treatment but resolved with hyperbaric oxygen (HBO2) therapy. HBO2 therapy may be an effective therapy for refractory renal abscess, adjunctive to surgical drainage and antibiotic therapy.

DOI:10.22462/614