14454              ACUTE PYELONEPHRITIS AND HYDRONEPHROSIS

The patient was a 45 year old man who had been unwell for one week and had abdominal pain for 4 days.  His urine contained albumin and was crowded with pus cells.  He died one day later after an epileptic fit which was precipitated by uraemia.

The specimen consists of a kidney which has been bisected.  The external surface is inflamed and there are large flat cortical scars.  The cut surface shows haemorrhagic inflammation of the renal cortex and medulla and to marked extent in the pelvis and ureter.  The cortex is irregularly attenuated and poorly distinguishable from the medulla.  Most of the papillae are destroyed by shaggy abscess cavities which are lined with grey slough.  The pelvis and the greater and lesser calyces are enlarged.