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CT scan of kidney reads mild heterogeneous perfusion in cortex of lower pole of left kidney. Suggest

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hi, i have been in hospital with kidney infection, my regular dr think its not a kidney infection, here is what the CT scan reads: However, there is mild heterogeneous perfusion in the cortex of the lower pole of the left kidney (series 4, image 18). No definite perfusion abnormalities detected on the right side. There is no perinephric fluid collection. Is my dr right for cause for concern- look forward to your reply. thanks! also my urine and blood work all showed normal results: But my regualr thinks these could be normal because all the antibiotics im on. I was in hosp for 4 days , been out 4 and still feel unwell and terrible back pain ? WBC 4.0 - 10.0 THOU/CU MM 8.0 RBC 3.90 - 5.25 M/UL 3.87 HEMOGLOBIN 12.0 - 15.0 GM/DL 12.4 HCT 36.0 - 45.0 % 37.0 MCV 81.0 - 99.0 CU MICRONS 95.6 MCH 27.0 - 33.0 UUG 32.2 MCHC 32.5 - 36.5 % 33.7 RDW 11.6 - 14.8 % 11.9 PLATELET COUNT 150 - 400 THOU/CU MM 234 LYMPH% 12.0 - 40.0 % 46.4 MONO% 4.0 - 12.0 % 5.5 NEUT% 40.0 - 74.0 % 43.5 EOSIN% 0.0 - 8.0 % 4.1 BASO% 0.0 - 2.0 % 0.5 ABSOLUTE LYMPH 1.0 - 4.0 THOU/CU MM 3.7 ABSOLUTE MONO 0.1 - 0.7 THOU/CU MM 0.4 ABSOLUTE NEUT 1.5 - 8.0 THOU/CU MM 3.5 ABSOLUTE EOS 0.0 - 0.6 THOU/CU MM 0.3 ABSOLUTE BASO 0.0 - 0.2 THOU/CU MM 0.0 The hosp did not culture this urine test, they threw it out! other cultures were fine. MUCOUS THREADS NOT SIGNIFICANT 2+ SQUAMOUS EPI 4+ HYALINE CASTS 0-1 BACTERIA NEGATIVE 2+ WBC, URINE 0 - 5 /HPF 6-10 RBC 0 - 4 /HPF 0-4 COLOR YELLOW APPEARANCE CLEAR SPECIFIC GRAVITY 1.005 - 1.030 1.020 PH 5.0 - 8.0 7.5 PROTEIN NEGATIVE 2+ GLUCOSE NEGATIVE GM/DL NEGATIVE KETONES NEGATIVE 5 BILIRUBIN, URINE NEGATIVE NEGATIVE BLOOD NEGATIVE NEGATIVE NITRITE NEGATIVE NEGATIVE UROBILINOGEN 0.1 - 1.0 EU 0.2 LEUKOCYTE ESTERASE NEGATIVE NEGATIVE
Posted Tue, 10 Dec 2013 in Kidney Conditions
 
 
Answered by Dr. Rakesh Madhyastha 5 hours later
Brief Answer: Urinary tract infection Detailed Answer: Hello Thanks for the query Your Urine test reports are indicative of a urinary tract infection and also they have noted bacterias in the urine. I suggest you to receive a 7 day course antibiotics for the same. If I were to be your physician I would send for a urine culture next and in the mean time I would empirically start you on Tab Oflox 200mg twice daily for 7 days. Please approach your physician with my suggestion Your CT report is not suggestive of any pyelonephritis or hydronephrosis (which basically suggests urine infection of the kidneys). Rest of your reports are normal. I hope I was of help, if you have any further queries please get back to me Regards
Above answer was peer-reviewed by
 
Follow-up: CT scan of kidney reads mild heterogeneous perfusion in cortex of lower pole of left kidney. Suggest 16 hours later
Hi thanks, I am on a 14 day of antibiotics yes, but the hospital did say I had pyelonephritis based on the Ct report, here is the full report. Please let me know if you think this case warrants seeing a Urologist, as a follow up. My PCP seems to think something else is going on, and not just a normal pyelo infection...please advise Thanks "There is symmetric excretion on the delayed imaging. However, there is mild heterogeneous perfusion in the cortex of the lower pole of the left kidney (series 4, image 18). No definite perfusion abnormalities detected on the right side. There is no perinephric fluid collection. The bladder is within normal limits.- IMPRESSION: 1. Heterogeneous enhancement at the lower pole of the left kidney, suspicious for pyelonephritis in the proper clinical setting. No evidence of abscess or obstruction.
 
 
Answered by Dr. Rakesh Madhyastha 7 hours later
Brief Answer: Pyelonephritis Detailed Answer: Hello Thanks for the reply I am sorry for the short delay in my reply, I was on call in my hospital. The CT scan and the urine routine are suggestive of pyelonephritis. Continue taking the antibiotics as prescribed and then repeat urine routine and culture at the end of the antibiotic course. As of now there is no indication to approach a urologist as there is no evidence of abscess or obstruction. Please approach your PCP with my suggestion. I hope I was of help Regards
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