A 62-year-old woman presented with a history of a slow growing flank mass since 2 months. She reported having recurrent UTIs. The USG showed a benign left renal cyst. No history of travel or trauma was given. Three weeks after the preliminary USG, this woman developed left flank pain with fever and chills along with night sweats and erythema over the affected area. She was started on oral cloxacillin 500 mg four times daily for six weeks however, there was no sign of improvement. A month later, the mass broke through the skin and started draining a serosanguinous fluid. She then developed nausea and vomiting and lost 15 kg weight.
Physical examination did not otherwise show any abnormalities. Laboratory investigations: Hb- 115 g/L (normocytic anemia). WBC count- 15.4 × 109/L. ESR- 85 mm/hr. CRP- 171 mg/L. Serum Creatinine- 71 µmol/L. CT scan- A large mass involving the left kidney,…
