Xanthogranulomatous pyelonephritis: an overview and management guide for clinicians.

Xanthogranulomatous pyelonephritis is a rare and chronic form of pyelonephritis. Patients can present with an array of signs and symptoms including flank pain, fever and weight loss. The insidious nature of its clinical presentation means that it can mimic a neoplastic process. Kidney stone disease, diabetes and female gender are the most common associated factors. Early diagnosis can be difficult, but is vital to avoid sequelae such as abscess formation and involvement of surrounding structures. Management requires a multidisciplinary approach. Definitive resolution can only be achieved through nephrectomy. This article provides an overview and guide to diagnosis, investigation and management.