ESPN 51th Annual Meeting

ESPN 2018


 
IS RENAL ABSCESS STILL A PROBLEM IN 2018?
IBRAHIM GOKCE 1 MEHTAP SAK 1 NESLIHAN CICEK 1 RABIA ERGELEN 2 NURDAN YILDIZ 1 HARIKA ALPAY 1

1- MARMARA UNIVERSITY MEDICAL SCHOOL DEPARTMENT OF PEDIATRIC NEPHROLOGY
2- MARMARA UNIVERSITY MEDICAL SCHOOL DEPARTMENT OF RADIOLOGY
 
Introduction:

Vesicoureteral reflux(VUR) and recurrent urinary tract infection(UTI) are still among the most common etiologies of end stage renal disease in Turkey. Renal abscess, the accumulation of infected fluid in the kidney is a rare condition and leads a long term hospital admission and antibiotic use. Lober nefronia, also known as acute focal bacterial nephritis, is the localized infection of the kidney without abcess formation and must be considered in differential diagnosis. Here, we reported three cases with renal abscess who hospitalized in our hospital in 2017.

Material and methods:

CASE REPORTS

Results:

Children with renal abscess were 4, 17 and 16 years old respectively.  The history of recurrent UTI was present only in the first case. Patients admitted to hospital with complaints of fever, vomiting, abdominal pain and flank pain. Growth and development of all children were normal.  Leukocytosis, elevated C-reactive protein level, slight deterioration in renal functions and pyuria were detected in the first 2 patients. Acute phase reactants of the third case were normal and she did not have pyuria in urinalysis. Her creatinine level increased to 5.6 mg/dl in the follow up and returned to normal levels without the need for renal replacement therapy. Renal abscesses were verified by magnetic resonance imaging and computed tomography. They were all treated with long-course intravenous antibiotic treatment untill renal abscess formation disappeared and none of the patients needed surgical abscess drainage.

Conclusions:

Urinalysis and radiologic imagining of the patients who admitted to hospital with complaints of fever, vomiting, abdominal pain or flank pain is important for the early diagnosis of UTI and renal abscess. It should be kept in mind that we can not exculude renal abscess even if the urinalysis is normal.