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Pediatric Nephrology

, Volume 30, Issue 11, pp 1987–1993 | Cite as

Acute focal bacterial nephritis, pyonephrosis and renal abscess in children

  • Maria Bitsori
  • Maria Raissaki
  • Sofia Maraki
  • Emmanouil GalanakisEmail author
Original Article

Abstract

Background-Aim

Acute focal bacterial nephritis (AFBN), renal abscess and pyonephrosis are uncommon and not fully addressed forms of urinary tract infection (UTI) which may be underdiagnosed without the appropriate imaging studies. Here, we review the characteristics and outcome of these renal entities in children managed at a single medial centre.

Patients and Methods

The medical files of all children hospitalized for episodes of AFBN, renal abscess and pyonephrosis during a 10-year period (2003–2012) were reviewed.

Results

Among the 602 children hospitalized for UTI, 21 presented with AFBN, one with abscess and three with pyonephrosis. All 25 children (13 girls), ranging in age from 0.06 to13.4 years, were admitted with fever and an impaired clinical condition, and 18 had urological abnormalities. More than one lesion, often of different types, were identified in 11 episodes. Urine cultures from 13 episodes grew non-Escherichia coli pathogens and those from two episodes were negative. Antibiotics were administered for 14–60 days, and emergency surgery was required in three cases. During follow-up, 13 patients underwent corrective surgery. Permanent renal lesions were identified in 16 patients.

Conclusions

AFBN, renal abscess and pyonephrosis should be suspected in children with severe presentation and urological history. Appropriate imaging is crucial for management planning. Prognosis is often guarded despite appropriate treatment. Based on the results of this study we propose a management algorithm.

Keywords

Acute focal bacterial nephritis Pyonephrosis Renal abscess Magnetic resonance urography Non-E. coli pathogens 

Notes

Conflict of interest

None

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Copyright information

© IPNA 2015

Authors and Affiliations

  • Maria Bitsori
    • 1
  • Maria Raissaki
    • 2
  • Sofia Maraki
    • 3
  • Emmanouil Galanakis
    • 1
    Email author
  1. 1.Department of PaediatricsHeraklion University HospitalHeraklionGreece
  2. 2.Department of RadiologyHeraklion University HospitalHeraklionGreece
  3. 3.Department of Clinical MicrobiologyHeraklion University HospitalHeraklionGreece

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