A Patient With Spontaneous Perinephric Hematoma: A Quiz

A 61-year-old white female patient with a history of hypertension and asthma with culture-negative L5-S1 lumbar diskitis was on intravenous cefepime, vancomycin, and minocycline for nearly 2 weeks when she presented with severe bilateral flank pain, hypotension, tachycardia, and severe anemia. She underwent a computed tomography abdomen and pelvis with intravenous contrast, which showed a right perinephric hyperdense lesion indicating hemorrhage, bilateral renal infarcts, and aneurysmal dilatation of the renal vessels.