Great #urology #medtwitter case; 55y female h/o recurrent proteus UTIs, 40lbs unintentional weight loss, bouts of pyelo... felt awful. In ED, fever 🤒 102, u/a ➡️infected, & non contrast CT scan showing:
ED w/ concern for broad differential including ♋️ RCC or other cancers, etc. History and labs/ imaging highly suspicious for XGP, xanthogranulomatous pyelonephritis. 
Gets drains (shows urine and proteus... lives with few drains for weeks and nutriton optimizes patient)...
Then she gets her “simple” #Nephrectomy. Difficult but success. Huge stones and nasty 🤢 kidney changes consistent with XGP.
Of note — prior to the nephrectomy, did do functional (MAG3) study showing minimal function! PCNL was not on the table. She’s doing great and felt like she has finally reclaimed her life. 😊 #urology rocks.
@threadreaderapp unroll
Also this thread would be better if narrated by @mikeroweworks
