A 29-year-old man presented to the emergency department with chest pain after ingestion of 25 tablets of 50 mg trazodone. Initial electrocardiography revealed a 3-mm ST-segment elevation in leads II, III, and aVF along with reciprocal ST-segment depression in anterior wall leads. Cardiac catheterization showed normal epicardial coronary arteries. His subsequent electrocardiograms showed resolution of ST-segment changes with uneventful recovery.
Acute lobar nephronia (ALN), also known as acute focal bacterial pyelonephritis, is a focal inflammation and bacterial infection of the kidneys without liquefaction or abscess formation. It is an interim between acute pyelonephritis and kidney abscess. ALN is a radiological diagnosis as clinical symptoms overlap with acute pyelonephritis (APN). ALN is more commonly reported in pediatric population and reports in adults are much more scarce likely due to under diagnosis. Imaging in adults is not routine for acute complicated UTI. ALN typically requires longer duration of antibiotics, and if suspected, clinicians should have a high degree of suspicion in order to obtain imaging studies for timely diagnosis, treatment and prevention of complications such as treatment failure or relapse. We present two cases of ALN in adults and a review of literature.
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