RESUMO
Introduction: Pyonephrosis is hydronephrosis accompanied by a bacterial infection in the kidney, causing suppurative destruction of the renal parenchyma; this condition is an emergency and usually associated with stones or chronic urinary tract infections. Urinalysis is typically inaccurate for establishing the diagnosis, as bacteriuria may not manifest due to ureteral obstruction. Case report: We reported a 55-year-old male patient with flanks pain and an account of stone expulsion. Based on history taking, physical examination, radiology examinations, and percutaneous nephrotomy, we concluded a diagnosis of pyonephrosis causing by Streptococcus agalactiae as known as Group B Streptococcus. Discussion: While both US and CT scan guided the early diagnosis, CT was more accurate as it is able to capture the renal function and the underlying cause of obstruction. Pyonephrosis was described as having a pus collection in the pelvicalyceal system, cortex thinning, and the appearance of stones. Conclusion: Pyonephrosis is a rare emergency, and many clinicians find it challenging to recognize since the presentations are frequently nonspecific. In order to prevent renal failure and the spread of bacteremia that entails life-threatening urosepsis, acquiring imaging knowledge (sonography and CT) and other findings are indispensable in determining this entity.
RESUMO
Tuberculosis (TB) is prevalent in underdeveloped and developing countries, mainly in rural areas, with indistinct clinical manifestations. Lungs are the most affected organs; however, tuberculosis may invade almost all human body systems, including the liver. We provided a case study of a young male adult with hepatic tuberculosis. The diagnosis was established by discovering hypodense nodules with rim enhancement in the liver on CT scan and granulomatous inflammation with caseating necrosis on biopsy. Although having unspecified clinical manifestations, novel liver imaging, combined with pathology examination, is capable of depicting the nature of this entity. Regarding the fact that Mycobacterium tuberculosis culturing may be challenging in most settings, imaging plays a vital role in diagnosing, treatment guiding, and patient follow-ups.
RESUMO
The peritoneal cavity is the second most common location for mesothelioma with only 10.5% of 10,589 mesothelioma cases reported in the United States between 1973 until 2005 and known with poor prognosis. Diagnosing malignant peritoneal mesothelioma is a challenge for many clinicians because the symptoms are often non-specific. Therefore, the emergence of computer tomography (CT) features knowledge and another finding is an essential aspect in establishing the diagnosis. We present a case 43-years-old man with no history of malignancy presented with abdominal distention, weight loss, and decreased appetite for 2 months. To pursue the proper diagnosis an abdominal CT was performed and revealed diffuse, irregular thickening of the parietal peritoneum with multiple nodules, and the chest CT revealed a left-sided pleural effusion with multiple nodules in both lungs. Concomitant with the imaging result, histopathological examination and immunohistochemical analysis of a core biopsy of the peritoneal nodule showed a malignant round cell tumor indicating the source of the mesothelioma.
