Abstract
BACKGROUND: Perirenal hematomas are commonly observed in patients with renal trauma; however, secondary infections are uncommon and often underdiagnosed. CASE PRESENTATION: An 82-year-old woman with a history of diabetes mellitus and liver cirrhosis presented to our emergency department with intermittent fever, malaise, and lower back pain 1 month after sustaining a fall. Contrast-enhanced computed tomography (CT) showed an 8-cm gas-containing left perirenal hematoma without urinary extravasation, and blood culture revealed Klebsiella pneumoniae. The patient was initially treated with intravenous antibiotics; however, CT-guided percutaneous drainage was eventually required for clinical and radiologic resolution. CONCLUSION: Delayed-onset infection in traumatic perirenal hematoma needs to be considered in high-risk patients for early definitive source control.