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Blood and urine cultures were negative. CT angiogram demonstrated bilateral wedge-shaped peripheral renal hypodensities suggestive of several peripheral infarcts with intrarenal microaneurysms. Treatment with steroids and cyclophosphamide was initiated, leading to significant clinical improvement. Review of the histological appendix specimen revealed features consistent with small-medium vessel vasculitis.<\/jats:p>","DOI":"10.1136\/bcr-2018-228072","type":"journal-article","created":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T13:58:40Z","timestamp":1549029520000},"page":"e228072","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Polyarteritis nodosa presenting atypically as appendicitis and pyelonephritis in a single patient"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3156-6731","authenticated-orcid":false,"given":"Matthew","family":"Corbitt","sequence":"first","affiliation":[{"name":"Griffith University School of Medicine, Gold Coast, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2711-6623","authenticated-orcid":false,"given":"Jagadeesh","family":"Kurtkoti","sequence":"additional","affiliation":[{"name":"School of Medicine, Griffith University \u2013 Gold Coast Campus, Southport, Queensland, Australia"},{"name":"Department of Renal Medicine, Gold Coast University Hospital, Southport, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muddassir","family":"Rashid","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gold Coast University Hospital, Southport, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonu","family":"Nigam","sequence":"additional","affiliation":[{"name":"Griffith University School of Medicine, Gold Coast, Queensland, Australia"},{"name":"Department of Pathology, Gold Coast University Hospital, Southport, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,2,1]]},"reference":[{"doi-asserted-by":"publisher","key":"2025082800450866000_12.2.e228072.1","DOI":"10.1016\/j.jaut.2014.01.029"},{"doi-asserted-by":"publisher","key":"2025082800450866000_12.2.e228072.2","DOI":"10.1016\/j.autrev.2016.02.015"},{"key":"2025082800450866000_12.2.e228072.3","first-page":"bcr2015209564","article-title":"Polyarteritis nodosa: an atypical presentation","volume":"2015","author":"Andrade","year":"2015","journal-title":"Case Rep"},{"key":"2025082800450866000_12.2.e228072.4","doi-asserted-by":"crossref","first-page":"bcr-2018-225762","DOI":"10.1136\/bcr-2018-225762","article-title":"Spontaneous bilateral perirenal and splenic haematoma in childhood onset polyarteritis nodosa","volume":"2018","author":"Shumy","year":"2018","journal-title":"BMJ Case Rep"},{"key":"2025082800450866000_12.2.e228072.5","doi-asserted-by":"crossref","first-page":"bcr-2018-225438","DOI":"10.1136\/bcr-2018-225438","article-title":"Abdominal pain leading to incidental finding of polyarteritis nodosa","volume":"2018","author":"Starobinska","year":"2018","journal-title":"BMJ Case Rep"},{"doi-asserted-by":"publisher","key":"2025082800450866000_12.2.e228072.6","DOI":"10.1136\/ard.2008.088096"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-228072","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:45:19Z","timestamp":1756367119000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-228072"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":6,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2,1]]},"published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1136\/bcr-2018-228072"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-228072","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,2]]}}}