Xanthogranulomatous Pyelonephritis: A Case Report and Review of the Literature

Xanthogranulomatous pyelonephritis (XGP) is a rare infectious urological emergency. It is a severe form of chronic pyelonephritis, often associated with urinary lithiasis and recurrent urinary tract infection. It can progress to progressive renal destruction. We report the case of a 23-year-old man, presenting for two years with left lumbar pain, associated with intermittent fever. Imaging revealed a ‘Bear’s Paw Sign’ upstream of a left renal pelvic stone on Uro-Tomodensitometry and a non-functioning left kidney on renal scintigraphy. He underwent emergency percutaneous nephrostomy followed by extended nephrectomy one month later. Pathological analysis confirmed the diagnosis of XGP. In this case, we discuss the epidemiological, clinical, radiological and therapeutic aspects of this rare condition.

Keywords: Xanthogranulomatous pyelonephritis; renal pelvic stone; Chronic urinary tract infections; Nephrectomy