Abstract
A 44-month-old girl known to have hyperimmunoglobulinemia E syndrome (HIE) presented with increasing abdominal girth due to a flank mass. She had been maintained on chronic dicloxacillin with good control of her skin and pulmonary infections. She had no fever or pain associated with the mass and no gastrointestinal or urinary symptoms. Imaging techniques revealed multiple, large cystic structures distorting the right kidney. Diagnostic aspiration of the largest cyst yielded pus containing Staphylococcus aureus. The perirenal abscesses were ablated with CT and ultrasound-assisted catheter drainage and intravenous nafcillin. A total of 750 ml of pus was drained. The patient continues to do well 12 months later. The presence of such a large asymptomatic abscess implies that any mass in a patient with HIE is very likely an abscess.
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