Is renal abscess still a problem?

Abstract

Renal abscess, the accumulation of infected fluid in the kidney, is a rare condition seen in children as well as adults. It leads to long term hospital admission and antibiotic use. Early diagnosis is an important factor in the outcome of renal abscess because the management may differ. Urinalysis test results and radiologic imaging findings of the patients who are admitted to hospital with complaints of fever, vomiting, abdominal pain or flank pain are important for the early diagnosis. Undertreated cases have high risk for renal scar formation. In this paper, we aim to present three pediatric patients, who showed the complication of renal abscess and were treated with long term antibiotic use without a need for surgical drainage.

Keywords

• Urinary tract infection
• Renal abscess
• Children

References

1. Chen CY, Kuo HT, Chang YJ, Wu KH, Yang WC, Wu HP. Clinical assessment of children with renal abscesses presenting to the pediatric emergency department. BMC Pediatr 2016; 16: 189. doi: 10.1186/s12887.016.0732-5.
2. Bibalo C, Apicella A, Guastalla V, et al. Acute lobar nephritis in children: Not so easy to recognize and manage. World J Clin Pediatr 2016; 5: 136-42. doi: 10.5409/wjcp.v5.i1.136.
3. Sheu JN, Wu KH, Chen SM, Tsai JD, Chao YH, Lue KH. Acute 99mTc DMSA scan predicts dilating vesicoureteral reflux in young children with a first febrile urinary tract infection: a population-based cohort study. Clin Nucl Med 2013; 38: 163- 68. doi: 10.1097/RLU.0b013e318279f112.
4. Rosenfield AT, Glickman MG, Taylor KJ, Crade M, Hodson J. Acute focal bacterial nephritis (acute lobar nephronia). Radiology 1979; 132: 553-61. doi: 10.1148/132.3.553.
5. Sheu JN. Acute Lobar Nephronia in Children. Pediatrics and Neonatology 2015; 56: 141 – 42. doi: 10.1016/j. pedneo.2015.03.001.
6. Nosher JL, Tamminen JL, Amorosa JK, Kallich M. Acute focal bacterial nephritis. Am J Kidney Dis 1988; 11: 36-42. doi: 10.1016/s0272-6386(88)80172-0.
7. Lee JK, McClennan BL, Melson GL, Stanley RJ. Acute focal bacterial nephritis: emphasis on gray scale sonography and computed tomography. AJR Am J Roentgenol 1980; 135: 87- 92. doi: 10.2214/ajr.135.1.87.
8. Choyke PL, Kressel HY, Pollack HM, Arger PM, Axel L, Mamourian AC. Focal renal masses: magnetic resonance imaging. Radiology 1984; 152: 471-7. doi: 10.1148/radiology. 152.2.6739818.

9. Sieger N, Kyriazis I, Schaudinn A, et al. Acute focal bacterial nephritis is associated with invasive diagnostic procedures – a cohort of 138 cases extracted through a systematic review. BMC Infect Dis 2017; 17: 240. doi: 10.1186/s12879.017.2336- 6.
10. Bitsori M, Raissaki M, Maraki S, Galanakis E. Acute focal bacterial nephritis, pyonephrosis and renal abscess in children. Pediatr Nephrol 2015; 30: 1987-93. doi: 10.1007/ s00467.015.3141-3.
11. Rubilotta E, Balzarro M, Lacola V, Sarti A, Porcaro A.B, Artibani W. Current clinical management of renal and perinephric abscesses. Urologia 2014; 81: 144-7. doi: 10.5301/ urologia.5000044.
12. Dalla Palma L, Pozzi Mucelli F, Ene V. Medical treatment of renal and perirenal abscesses: CT evaluation. Clin Radiol 1999; 54: 792-7. doi:10.1016/s0009-9260(99)90680-3.
13. Lee SH, Jung HJ, Mah SY, Chung BH. Renal abscesses measuring 5 cm or less: outcome of medical treatment without therapeutic drainage. Yonsei Med J 2010; 4: 569-73. doi: 10.3349/ymj.2010.51.4.569.
14. Raghavan R, Eknoyan G. Acute interstitial nephritis – a reappraisal and update. Clin Nephrol 2014; 82: 149-62. doi: 10.5414/cn108386.