Clinical Features of Acute Focal Bacterial Nephritis in Children

Abstract

Background: Acute focal bacterial nephritis (AFBN) is a localized bacterial infection of the kidneys. Patients present with an inflammatory mass without frank abscess formation, which may represent a relatively early stage of renal abscess. In children, most patients with AFBN present with non-specific findings of fever and flank or abdominal pain. Methods: From 2008 to 2011, AFBN was diagnosed in 11 children at the Department of General Pediatrics, Nihon University Nerima Hikarigaoka Hospital, Tokyo, Japan. Clinical data of 11 cases (four girls and seven boys) with a mean age of 5.4 years (range 2- 8 years) were available for retrospective evaluation. Results: All children presented with fever and rapid deterioration of their clinical condition. Six children suffered from gastrointestinal symptoms such as vomiting and abdominal pain. Four children suffered from neurological symptoms, including meningeal irritation, unconsciousness, and seizure. In renal ultrasonography, abdominal findings were seen in four patients. However, abdominal enhanced computed tomography (CT) was indispensible for diagnosis of AFBN in these patients. Conclusions: We recommend that abdominal enhanced CT should be performed for patients with fever of unknown origin. AFBN should be suspected in children with fever and rapid deterioration of clinical condition. Int J Clin Pediatr. 2013;2(2):68-73 doi: http://dx.doi.org/10.4021/ijcp115w