[Acute lobar nephronia: Diagnosis, treatment and prognosis]

Area of Science:

• Nephrology
• Radiology
• Infectious Diseases

Background:

• Acute lobar nephronia is a rare focal bacterial infection of the kidney.
• Its low prevalence and often insidious presentation can delay diagnosis.

Observation:

• Four cases are presented, with three diagnosed during acute pyelonephritis admissions.
• One atypical case was associated with epidermolysis bullosa.
• Renal ultrasonography was the primary diagnostic tool, with CT confirming in complex cases.

Findings:

• Urine cultures were positive in 75% of cases.
• A small renal abscess was detected in one patient.
• Diagnosis relies heavily on radiological findings due to potentially contradictory clinical and lab data.

Implications:

• Acute lobar nephronia requires prompt diagnosis and aggressive management to prevent renal abscess formation.
• Clinicians should maintain a high index of suspicion in patients with poor clinical course or abnormal renal ultrasound findings.
• While challenging to diagnose, medical treatment is often effective, leading to a generally favorable prognosis.