Treatment of focal xanthogranulomatous pyelonephritis with antibiotics

Rasoulpour, Majid; Banco, Leonard; Mackay, Iain M.; Hight, Donald W.; Berman, Martin

doi:10.1016/s0022-3476(84)80018-9

Cited by 16 publications

(3 citation statements)

References 14 publications

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“…A few patients with focal XGP can be treated medically (Rasoulpour et al, 1984) but surgical treatment is needed in most cases. Partial nephrectomy may be done for focal XGP, especially in patients with a solitary kidney (Tolia et al, 1981).…”

Section: Discussionmentioning

confidence: 99%

Xanthogranulomatous Pyelonephritis in Children and Adults

Kural¹,

Akaydin²,

Öner³

et al. 1987

British Journal of Urology

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Section: Discussionmentioning

confidence: 99%

Xanthogranulomatous Pyelonephritis in Children and Adults

Kural¹,

Akaydin²,

Öner³

et al. 1987

British Journal of Urology

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“…16 Huang and Chen and Rasoulpour et al described good outcomes with medical management on stages I and II. 17 , 18 There have been other successful reports with nonsurgical approaches of focal XPN on pediatric literature, from as young as 2 years old. 19 - 24 Although most cases are unilateral, a favorable evolution with prolonged systemic antibiotic therapy on bilateral focal XPN had also been stated.…”

Section: Discussionmentioning

confidence: 99%

Neonatal Urinary Tract Infection and Renal Nodular Lesion: A Rare Case of Xanthogranulomatous Pyelonephritis

Morais

Gomes

Fragoso

et al. 2022

Journal of Investigative Medicine High Impact Case Reports

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Xanthogranulomatous pyelonephritis (XPN) is an uncommon variant of chronic pyelonephritis with a poorly understood pathogenesis and a challenging diagnosis. It is rare in pediatric patients, particularly in the neonatal period. We report the case of an 18-day-old female neonate admitted to the emergency room due to macroscopic hematuria and poor feeding. Urinalysis revealed leukocyturia and she was initially admitted under the clinical suspicion of acute pyelonephritis. Renal ultrasound and magnetic resonance imaging (MRI) revealed a progressive nodular lesion in the middle third of the left kidney. Given the suspicion of renal abscess or neoplasm, the patient was transferred to our tertiary hospital. Urinary catecholamines and tumor markers had normal values. Percutaneous kidney biopsy confirmed XPN. Posterior computed tomography scan excluded extension to neighboring structures. A conservative management with systemic antibiotic therapy was decided. She completed 7 weeks of systemic antibiotic therapy (ampicillin and cefotaxime) with progressive reduction of lesion size and posterior calcification. Follow-up at 3 years was uneventful. The lipid profile and study of neutrophil function were normal. Voiding cystourethrography excluded vesicoureteral reflux. The authors intend to highlight the importance of a high index of suspicion of XPN to allow preoperative diagnosis. Histopathological assessment is mandatory to confirm XPN and exclude other entities mimicked by focal and unilateral progressive disease. There are only a few published cases of optimal clinical evolution solely with broad-spectrum antibiotics; however, this may allow a beneficial nephron-sparing approach in selected patients.

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“…Debate exists regarding medical management of XGP due to potential for malignancy [ 21 ]. A few case reports describe non-operative medical management of XGP with antibiotics alone [ 9 , 82 , 83 ]; though there are also reports of patients proceeding to nephrectomy after failure of medical management [ 80 ]. Upasani and colleagues reported a case of a 17 year old male with XGP who underwent embolization of the renal artery to devascularize the involved renal parenchyma and ablate the infected portion to avoid repeat surgery after initial attempts at nephrectomy failed [ 7 ].…”

Section: Discussionmentioning

confidence: 99%