Case 409

Medical history

A 47-year-old female presents to the emergency department complaining of back and left flank pain for two weeks. She also presents weakness and bilious vomiting. Recently, she was treated for urinary tract infection, with no improvement. On examination, the patient is pale (1+/4+), afebrile in regular general state, there are diffusional abdominal pain, mass presence on the left and costovertebral angle tenderness on the same side. Laboratory findings: Hb 5,9 g/dL, global leukocytes 13900/mm3, CRP 220 mg/L, urinalysis revealed 15 leukocytes/camp and no presence of bacteria.

Considering the case above and the images findings, what is the next step in treatment?

Test question

Secretaria Estadual de Saúde - PE: Processo Seletivo de residência médica, 2019.

About Xanthogranulomatous Pyelonephritis, it is CORRECT to state that:

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