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Kidney Diseases

Why Getting Kidney Infections & Abcesses

02/19/2010

Question:

This is now the second time I was diagnosed with a kidney infection and a kidney abscess that went septic.

First, this time they did not drain the abscess. Yes I was hospitalized and iv of fluids & antibiotics then sent home with Cypro. Yes I was very very sick! Now I`ve finished nearly 3 weeks of antibiotics. Two days after stopping the antibiotics, I`m starting to feel sick again. I have severe night sweats (that subsided towards the end of antibiotics) but now they are back. I`m going to the dr. this morning to ask about the abscess. Could it be that I`m still infected? Does the abscess always need to be drained?

Second question is why am I getting these kidney infections and kidney abscesses? I`m suspecting there is a genetic disorder here. My 1st cousin`s kidneys failed (they don`t know why). She just had a transplant two weeks ago. Others on this side of the family also have kidney problems. Nobody`s symptoms are the same though. As a child I spilled alarming amounts of protein in my urine. However, as an adult, nobody has ever mentioned it. How can I prevent these infections and abscesses from happening again? Not knowing I`m sick until I`m septic is too dangerous of a way to live my life. Yes I urinate before and after sex (I`m female). No I don`t seem to have symptoms of bladder infections (doesn`t mean I don`t get them and they don`t travel upwards). I have a gut feeling that I have a water processing problem. I can`t explain it but I really think my basic problem has to do with water. I do drink lots of water. Do I drink tons of water? No but I have increased my intake tremendously. It doesn`t seem like it`s helping. Oh yeah, I`ve had unexplained kidney pain for years that they`ve finally discounted. I can`t help but wonder what is going on here behind the scenes that nobody is finding.

Where to start and what to do? I look forward to hearing your advice.

Answer:

By now, you have probably received treatment for your abscess(es) again, but here are some thoughts that may help:

1) Have you had imaging of your kidneys to see if there is a genetic disease, such as polycystic kidney disease, that may be making you susceptible to infections and abscesses?

2) Even if there is no genetic disease that can be identified, you may have an anatomic or structural abnormality that is interfering with urine (and therefore bacteria) being normally washed out of the kidney.  It is concerning that you mention having protein in your urine as a child -- this suggests that you do have underlying kidney disease, which may be making the kidney more susceptible to infection and abscess formation.

3) If you are drinking at least 3-4 glasses/day of water/liquids, then increasing your intake more probably won't make any difference in preventing infection.

4) Abscesses in or around the kidney do not necessarily need to be surgically drained -- if small (less than 5 cm in diameter), they may respond well just to IV antibiotic therapy.

You should be under the care of a nephrologist (medical kidney doctor) as well as a urologist (surgical kidney doctor) -- occasionally, with recurring kidney infections, the only thing to do is to remove all, or at least the infected part, of the kidney. 

Best of luck to you, and I hope that everything works out for you.

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Response by:

Mildred   Lam, MD Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University