Urinalysis and urinary gram stain were positive, which prompted the initiation of empirical therapy with broad-spectrum antimicrobials. Initial laboratory results reported normocytic and hypochromic anemia, thrombocytosis, and leukocytosis with slight neutrophilia. In addition, the patient brought a urinary tract echography performed five days before the admission, which showed a 5x1.2-cm mobile anechoic structure within the right lumbar region. The patient's past medical history included arterial hypertension, a left ventricular ejection fraction (LVEF) of 49%, and the removal of a giant auricular myxoma along with mitral valve vegetation abscission. The rest of the physical examination was normal, except for the palpable mass previously described and right costovertebral angle tenderness. On admission, he weighed 44 kg, was afebrile, and without urinary symptoms. Additionally, the patient stated that he occasionally experienced fever and urinary symptoms and had lost approximately 8.4% (4 kg) of his body weight (48 kg). In light of this, this report presents the case of a patient with xanthogranulomatous pyelonephritis and compares its main findings with those of different renal tumors and pseudotumors that can imitate common renal and genitourinary pathologies, which have vastly different etiologies.Ī 55-year-old male patient from Soledad, Colombia, presented to the primary care center due to a two-month clinical condition characterized by a 7x7-cm palpable mass in his right lumbar region, which was hot and painful upon touch and progressively increasing in size. Furthermore, this issue varies from place to place due to sociodemographic factors, which enhance diagnostic possibilities.

Still, not much is known about pathologies that simulate typical renal lesions, or they remain underdiagnosed due to a lack of knowledge about their existence or detection methods. As a result, we find ourselves confronted with increasingly prevalent illnesses of rising incidence whose physiopathology, treatment, and survival rate can be clearly estimated. Ĭurrently, we rely on significant advances in renal pathology that have resulted in quick methods with great sensibility and specificity and specific clinical characteristics that enable physicians to establish an early diagnosis. Therefore, the diagnostic confirmation of this disease can be challenging. Despite that, it might have an insidious course, and it is vital to keep neoplasms in mind for its differential diagnosis. Some of its typical signs and symptoms include fever, loss of weight, and flank pain, but its presentation is mainly variable.

Xanthogranulomatous pyelonephritis is an uncommon subtype of pyelonephritis, representing 0.6% of all varieties of its chronic presentation.

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