Keywords
urinary tract infection
renal abscess
pyelonephritis
infant
chronic kidney disease
How to Cite
Abstract
Background: Acute lobar nephronia (ALN) or acute focal nephritis is a little-known complication of an infectious process of the urinary tract, with a focal, acute and non-suppurative nature, which affects one or more renal lobes; its pathogenesis is generally ascending, its clinical manifestations are insidious and imaging support is necessary for its diagnosis, it requires a targeted and prolonged antibiotic treatment, its prognosis depends on its suspicion and adequate therapy, but above all timely and early. The case of a 9-month-old infant treated in an institution in Bogotá (Colombia) is presented.
Purpose: Since the case of a pathology with low incidence and limited literature is described, due to its low prevalence in both children and adults, the aim of this article was to perform a case report and a literature search review of this topic in scientific databases such as PubMed, Embase, Science Direct and Lilacs, to increase the available information on ALN in an infant.
Case presentation: A case of acute lobar nephronia is presented in a 9-month-old patient with a complicated urinary tract infection that remained symptomatic despite management. A focal right renal mass was subsequently detected by ultrasound, which was later characterized by computed tomography, and had complete resolution after treatment with antibiotics for 14 days.
Discussion and conclusion: Acute focal nephritis (NLA) is a complication of urinary tract infections. It is characterized by renal inflammation without areas of liquefaction and necrosis, unlike renal abscess, and its pathophysiology is associated with bacterial ascension to the kidney. Although its diagnosis can be complicated by its similarity to other conditions such as Wilms tumor, ultrasound and CT are key to differentiate it. The mainstay of treatment is antimicrobial therapy directed according to microbiological isolation and rarely requires surgical intervention.
NLA is a rare pathology in children, with variable and nonspecific clinical presentation. Clinical and paraclinical characteristics and mainly imaging findings that suggest NLA must be taken into account for its diagnosis to facilitate timely treatment and thus reduce the risk of short- and long-term complications.
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