There are some
reports of
renal vein thrombosis associated with acute
pyelonephritis, but a case of
renal artery thrombosis in acute
pyelonephritis has not been reported yet. Here we
report a case of
renal artery thrombosis which developed in a
patient with acute
pyelonephritis complicated with
sepsis-induced
disseminated intravascular coagulation (
DIC). A 65-year-old
woman with diabetes was diagnosed with acute
pyelonephritis complicated with
sepsis.
Escherichia coli was isolated from both
blood and
urine cultures. When treated with
antibiotics, her condition gradually improved. She suddenly complained of severe
right flank pain without
fever in the recovery phase. A computed
tomography scan revealed right
renal artery thrombosis with concomitant renal
infarction. Prophylactic anticoagulation
therapy was not suggested because of sustained
thrombocytopenia and increased
risk of
bleeding.
Flank pain resolved with
conservative treatment and
perfusion of infarcted
kidney improved at the
time of discharge. To our
knowledge, this is the first case of
renal artery thrombosis related to acute
pyelonephritis with
sepsis-induced
DIC.