Abstract
BackgroundAcute focal bacterial nephritis (AFBN) is a rare disease currently described only in case reports and small case series. In this study we summarize the clinical features of AFBN as has been documented in the literature and draw recommendations on the proper diagnosis and therapy.MethodsA systematic literature review was undertaken in PUBMED, Web of Science and The Cochrane Library online databases for relevant literature on AFBN in adults.ResultsLiterature review revealed a total of 38 articles according to our inclusion criteria, of which we could extract data from 138 cases of AFBN. Fever (98%) and flank pain (80%) were most commonly reported symptoms. E. coli was the most frequent pathogen. Diagnosis was set by CT and/or MRI (52%) with or without sonography or by sonography alone (20%) as well as by sonography combined with IVU. In total, sonography was applied in 83% of cases. All but one patient received antibiotic treatment. Kidney lesions were occasionally mistaken for neoplasms or renal abscesses and as a result, cases were subjected to percutaneous puncture (12.3%), surgical exploration (5.1%) and partial or radical nephrectomy (4.4%). Four cases (2.9%) developed a renal abscess.ConclusionsThe diagnosis of AFBN is set by characteristic clinico-radiological findings. Differential diagnoses of this interstitial bacterial infection include renal abscess and tumor. Correct diagnosis is occasionally impeded by atypical symptoms. Invasive diagnostic and therapeutic procedures should be limited as the majority of cases respond well to conservative treatment.
Highlights
Acute focal bacterial nephritis (AFBN) is a rare disease currently described only in case reports and small case series
Sonography was applied in 83% of cases (solely or combined with intravenous urography (IVU) and/or computed tomography (CT) and/or magnetic resonance imaging (MRI))
As our dataset is dependent on individual authorsreports, a selection and reporting bias is present; AFBN cases undergoing an uneventful course are less likely to be reported than cases with adverse outcomes; overtherapy (e. g. nephrectomy) in a case of AFBN is not commendable and less likely to be reported
Summary
Acute focal bacterial nephritis (AFBN) is a rare disease currently described only in case reports and small case series. In this study we summarize the clinical features of AFBN as has been documented in the literature and draw recommendations on the proper diagnosis and therapy. Acute focal bacterial nephritis was first described in 1978 by Rosenfield et al [1]. It was named “acute lobar nephronia”, in analogy to acute lobar pneumonia, as the anatomic extent of the infection is sometimes determined by the renal lobes. AFBN is a rare focal bacterial interstitial infection of the kidney presenting with characteristic focal lesions in radiological imaging (Fig. 1). Focal lesions seen in AFBN are occasionally misdiagnosed and patients are at
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
