Abstract
To investigate clinical features, laboratory, and imaging characters in Chinese children, we conducted a retrospective study on 14 children with acute focal bacterial nephritis (AFBN) admitted in Beijing Children’s Hospital during January 2005 to December 2009. Six girls and eight boys with a mean age of 4.7 years (range: 0.3-11.4 years) were followed up on average 1.7 years (range: 0.5-3.5 years). Leukocyturia was found in 10/14 children. Urine cultures were positive in 10/14 cases; E. coli was the most common cause of AFBN. A combination of nephromegaly and focal mass was found in 11/14 patients. Urinary tract anomalies were found in 8 children. Two boys had underlying disease of acute lymphatic leukemia under chemotherapy. AFBN resolved on average 3-12 weeks after therapy. Ultrasound and enhanced CT were not necessary in cases of fever of unknown origin, even if pyuria nor urine culture is positive. Vesicoureteral reflux (VUR), malignancy and renal vascular malformation are potential risk factors of AFBN; careful radiological investigations should be performed. Key words: Acute focal bacterial nephritis, vesicoureteral reflux, children.
Highlights
Acute focal bacterial nephritis (AFBN) is a localized bacterial infection of the kidney presenting as an inflammatory mass not containing drainable pus
C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell count (WBC) were raised in all children; serum creatinine levels and glomerular filtration rates determined by Schwartz formula (Schwartz et al, 1976) were calculated in all cases
Older children with acute focal bacterial nephritis (AFBN) presented specific findings of flank pain or symptoms related to urinary system
Summary
Acute focal bacterial nephritis (AFBN) is a localized bacterial infection of the kidney presenting as an inflammatory mass not containing drainable pus. AFBN typically involves one or more renal lobules. Rosenstein originally called it acute lobar nephronia (ALN) (Rosenfield et al, 1979). The first report of AFBN in children was published in 1985 (Lawson et al, 1985). Pathological examination reveals hyperemia, interstitial edema, and infiltration of leukocytes, but not necrosis or liquefaction (Montejo et al, 2002). Septicemia due to respiratory tract infections or ascending infection of the lower urinary tract is suspected. For the majority of children, the pathogenesis may be related to ascending infection. The most common pathogen is E. coli, other bacteria can cause it as well
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