Staghorn Calculus and Xanthogranulomatous Pyelonephritis Complicated by Inflammation of the Vena Cava

Abstract

A 30-year-old female with multiple presentations for pyelonephritis was diagnosed with Xanthogranulomatous pyelonephritis (XGP) by computed tomography (CT) scan. This patient was intermittently symptomatic for 8-years with numerous healthcare encounters without the correct diagnosis. The patient was treated recurrently for pyelonephritis with transient clearing of her symptoms without diagnostic imaging. The prolonged nature of her disease likely resulted in a complicated surgical course with inflammation of her liver and inferior vena cava. XGP is an uncommon disease characterized by chronic infection and inflammatory process resulting in the destruction of the kidney. The disease affects both adults and children, has a female pre dominance and is usually unilateral. An obstructive process and bacterial infection are contributing factors. The disease can be complicated by locally invasive and seeding infection, abscess development and systemic disease. Treatment consists of temporization with antibiotics and nephrectomy.