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Introduction: Diagnosis and proper treatment of renal abscesses remain a challenge for physicians. Reports have illustrated that small renal abscesses could be effectively treated with a course of intravenous antibiotics. However, delay in diagnosis and treatment could lead to higher morbidity and mortality. Case Report: We present a 43-year-old female with a small renal abscess after incomplete treatment of acute pyelonephritis, which was associated with renal stone and Escherichia coli bacteremia. Patient was then treated with enough intravenous antibiotics without any classical surgical drainage, and came out to be fully healthy. Conclusion: This case highlights the need for early identification of risk factors as well as the subtle feature of renal abscess by proper diagnosis and adequate treatment.

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