lobar nephronia

 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.

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References:

1. Demertzis J, Menias CO. State of the art: imaging of renal infections. Emerg Radiol 2007; 14:13. 

2. Rosenfield AT, Glickman MG, Taylor KJ, et al. Acute focal bacterial nephritis (acute lobar nephronia). Radiology 1979; 132:553. 

3. Talner LB, Davidson AJ, Lebowitz RL, et al. Acute pyelonephritis: can we agree on terminology? Radiology 1994; 192:297.