Which condition is defined by pus in the collecting system and can be accompanied by septic shock?

Which condition is defined by pus in the collecting system and can be accompanied by septic shock?

• A. Pyonephrosis
• B. Hydronephrosis
• C. Lymphocele
• D. Urinoma

Answer: (A)

Pus in the renal collecting system signals pyonephrosis, a suppurative infection that occurs when obstruction traps infected urine. This condition is an emergency because the infection can spread, leading to septic shock. On imaging, you’d expect a dilated collecting system with internal echogenic debris or pus, and the management centers on urgent decompression—via percutaneous nephrostomy or ureteral stent—along with broad-spectrum antibiotics to drain the infected material and control sepsis. Hydronephrosis, in contrast, is simply dilation of the renal pelvis and calyces from obstruction without intraluminal pus. A lymphocele is a post-surgical lymphatic fluid collection, not an infected collecting system. A urinoma is a urine collection from a leak and does not inherently contain pus in the collecting system.

Pus in the renal collecting system signals pyonephrosis, a suppurative infection that occurs when obstruction traps infected urine. This condition is an emergency because the infection can spread, leading to septic shock. On imaging, you’d expect a dilated collecting system with internal echogenic debris or pus, and the management centers on urgent decompression—via percutaneous nephrostomy or ureteral stent—along with broad-spectrum antibiotics to drain the infected material and control sepsis. Hydronephrosis, in contrast, is simply dilation of the renal pelvis and calyces from obstruction without intraluminal pus. A lymphocele is a post-surgical lymphatic fluid collection, not an infected collecting system. A urinoma is a urine collection from a leak and does not inherently contain pus in the collecting system.