Acute Nephronia and Renal Abscesses in Children from Quito, Ecuador

Abstract

Renal abscess and nephronia are uncommon diseases in children and with unknown global prevalence. Nephronia represents an intermediate state between pyelonephritis and renal abscess. Prompt diagnosis is important to prevent morbidity and mortality (sepsis, renal injury, death). Scientific advances have made these entities more evident, although they may still be underdiagnosed. Patients with this disease require prolonged intravenous antibiotic therapy and potentially surgical resolution, mostly when their size is bigger than 3 - 5 cm when therapy with intravenous antibiotics alone fails and they are accessible to percutaneous drainage. We describe five cases of pediatric patients from four private hospitals in Quito, Ecuador followed during a one-year period. In every case, the diagnosis was suspected mostly because of persistent fever, abdominal pain, severe leukocytosis and/or elevated inflammation biomarkers. Only one of them had a previous history of urinary tract malformation while in another one malformation was revealed in his actual admission. Every case had microbiologic isolation. All of them recovered successfully. To our knowledge, in our country, there are no previous reports of these diseases in pediatric patients, and worldwide, there is scarce data. Our aim is to alert doctors who work with children to be aware of this condition.