Renal Abscess in Children

Cheng, Chi-Hui; Tsai, Ming-Horng; Su, Lin; Wang, Chao Ran; Lo, Wan Chak; Tsau, Yong-Kwei; Lin, Ghi Jen; Huang, Yhu Chering; Chiu, Cheng Hsun; Lin, Tzou Yien

doi:10.1097/inf.0b013e31817b617b

Cited by 52 publications

(29 citation statements)

References 15 publications

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“…The female to male ratio of pediatric renal abscess in our study was 1.4:1. This result is similar to the largest study of pediatric renal abscess in which the female to male ratio was 1.7:1 [4]. As previously reported, the most common predisposing risk factors of renal abscesses in adults are diabetes mellitus, nephrolithiasis, and ureteral obstruction [11, 12].…”

Section: Discussionsupporting

confidence: 89%

“…Renal abscesses are relatively uncommon in children but may result in a prolonged antibiotic course, increased length of hospital stay, high treatment cost, or life-threatening complications [1–4]. The clinical presentation of renal abscess may be nonspecific, and can include fever, nausea/vomiting, flank pain, abdominal pain, elevated erythrocyte sedimentation rate, leukocytosis, and positive blood/urine cultures [3–5].…”

Section: Introductionmentioning

confidence: 99%

“…With the progressive improvement of ultrasonography (US) and computed tomography (CT), a definitive diagnosis of renal abscess may be made more readily than was previously possible [4, 6]. However, renal abscesses may be difficult to distinguish from certain renal lesions on US or some renal diseases based on clinical assessment, such as acute pyelonephritis, acute lobar nephronia, and renal mass [7].…”

Section: Introductionmentioning

confidence: 99%

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Clinical assessment of children with renal abscesses presenting to the pediatric emergency department

et al. 2016

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BackgroundRenal abscesses are relatively uncommon in children but may result in prolonged hospital stays and life-threatening events. We undertook this study to analyze the clinical spectrum of renal abscesses in children admitted to the pediatric emergency department (ED) and to find helpful clinical characteristics that can potentially aid emergency physicians for detecting renal abscesses in children earlier.MethodsFrom 2004 to 2011, we retrospectively analyzed 17 patients, aged 18 years or younger, with a definite diagnosis of renal abscess admitted to the ED. The following clinical information was studied: demographics, clinical presentation, laboratory testing, microbiology, imaging studies, treatment modalities, complications, and long-term outcomes. We analyzed these variables among other potential predisposing factors.ResultsDuring the 8-year study period, 17 patients (7 males and 10 females; mean age, 6.1 ± 4.5 years) were diagnosed with renal abscesses on the basis of ultrasonography and computed tomography findings. The 2 most common presenting symptoms were fever and flank pain (100% and 70.6%, respectively). All of the patients presented with leukocytosis and elevated C-reactive protein (CRP) levels. Organisms cultured from urine or from the abscess were identified in 11 (64.7%) patients, and Escherichia coli was the most common organism cultured. All patients were treated with broad-spectrum intravenous antibiotics with the exception of 4 children who also required additional percutaneous drainage of the abscess.ConclusionsRenal abscesses are relatively rare in children. We suggest that primary care physicians should keep this disease in mind especially when children present with triad symptoms (fever, nausea/vomiting, and flank pain), pyuria, significant leukocytosis, and elevated CRP levels. However, aggressive percutaneous drainage may not need to be routinely performed in children with renal abscesses.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical assessment of children with renal abscesses presenting to the pediatric emergency department

et al. 2016

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“…Ultrasound may identify a renal abscess on the basis of its thick wall surrounding a fluid cavity. Computerized tomography (CT) with contrast enhancement remains the best imaging modality for evaluation of renal or perinephric abscess and its extension to adjacent structures [55]. …”

Section: Imaging and Recurrent Utimentioning

confidence: 99%

The diagnosis, evaluation and treatment of acute and recurrent pediatric urinary tract infections

Becknell

Schober

Korbel

et al. 2014

Expert Review of Anti-infective Therapy

105

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Urinary tract infection is one of the most common bacterial infections encountered by pediatricians. Currently, the diagnosis and management of acute urinary tract infection and recurrent urinary tract infection in children remains controversial. Recently published guidelines and large clinical trials have attempted to clarify UTI diagnostic and management strategies. In this manuscript, we review the diagnosis and management of acute and recurrent urinary tract infection in the pediatric population.

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“…It must be kept in mind that ultrasound at the initial stages of the disease maybe negative as findings may be missed or may not be obvious at the early carbuncle stage. Hence repeat ultrasound or more sensitive imaging like CT scan should be done when in doubt (Cheng et al 2008). Late diagnosis can be catastrophic with spread and rupture of the abscess.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Renal Cortical Abscesses Presenting as Pyrexia of Unknown Origin in an Immunocompetent Individual

Sarkar¹,

Banik²,

Sadhukhan³

et al. 2015

American Journal of Infectious Diseases

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The diagnosis of renal cortical abscess can be missed as the condition is frequently associated with blood and urine culture negativity. Moreover, imaging by ultrasonography in the early stages of the disease may miss small or developing abscesses and carbuncles. Renal abscesses being more common in the immunosuppressed, the condition may be overlooked in the immunocompetent. We report a case of bilateral renal cortical abscesses in an immunocompetent individual who presented to us with Pyrexia of Unknown Origin (PUO). The patient's urine and blood culture were negative and initial ultrasonography of the abdomen revealed no abnormality. Based on clinical suspicion a repeat ultrasonography was done, which detected bilateral renal cortical abscesses. Thus, when in doubt repeat or more sensitive imaging is required for correct diagnosis. Important differences exist between renal cortical and cortico-medullary abscesses and this awareness guides therapeutic decision. Missing a renal cortical abscess based on single negative imaging could be catastrophic.

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Renal Abscess in Children

Cited by 52 publications

References 15 publications

Clinical assessment of children with renal abscesses presenting to the pediatric emergency department

Clinical assessment of children with renal abscesses presenting to the pediatric emergency department

The diagnosis, evaluation and treatment of acute and recurrent pediatric urinary tract infections

Bilateral Renal Cortical Abscesses Presenting as Pyrexia of Unknown Origin in an Immunocompetent Individual

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