A PATH OF INFECTION IN PERINEPHRITIS

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Abstract
Last year, before the Chicago Urological Society, Dr. Burstein and I reviewed a series of fifty-five cases of perinephritic abscess.1 Thirty-two were metastatic in origin. The metastatic abscesses are of particular interest because they are usually diagnosed only when the condition has become well developed. They are, in the vast majority of cases, primarily cortical abscesses of the kidney,2 thus accounting for the difficulty in their diagnosis. The abscess at first does not communicate with the renal pelvis, so that the urinary and pyelographic findings are negative until some weeks later, when the abscess has extended and communicates with the pelvis. The outer capsule undergoes inflammatory reaction and encapsulates the abscess, and thus here also evidence does not usually present itself until the abscess has spread into the perinephric tissue, when it is possible to make the diagnosis by the presence of a tumor, the finding of pus

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