Q: 66 years old female is admitted to ICU with urosepsis. CT scan report reads "lobar nephronia". What is lobar nephronia?
Answer: "Lobar nephronia", a term described almost four decades ago, is a CT scan finding evident only with intravenous (IV) contrast. This is unlike renal abscess which can be seen without IV contrast. Diabetes is the highest risk factor.
It is present as a single round or wedge-shaped hypodense image in single lobe on a CT scan. It is usually not very well defined. It is a concerning sign of renal ischemia and mostly presents due to bacterial infection. It may progress to necrosis, a walled-off cavity, and eventually to cortical scarring.
References:1. Demertzis J, Menias CO. State of the art: imaging of renal infections. Emerg Radiol 2007; 14:13.