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[Renal calculi in an infant]
1Urologisk afdeling, Aalborg Sygehus Nord.
Insights
Urinary tract infections caused by Bacillus Proteus can lead to kidney stones in children. This study presents the youngest case of a pelvic concretion, successfully treated with pyelolithotomy.
Area of Science:
- Pediatric Urology
- Infectious Diseases
- Nephrology
Background:
- Urinary tract infections (UTIs) caused by Bacillus Proteus are associated with the formation of urinary concretions, particularly in European countries.
- While common elsewhere, such occurrences are notably rare in Scandinavia.
- Bacillus Proteus possesses urease, an enzyme presumed to facilitate calculus formation.
Observation:
- A case report details an obstructing pelvic concretion in a three-month-old boy, representing the youngest documented instance.
- The infant's pain was initially misdiagnosed as infantile colic.
- Surgical intervention, pyelolithotomy, was performed.
Findings:
- The child has remained recurrence-free for six years post-surgery.
- The presumed mechanism of stone formation involves Bacillus Proteus-induced urease activity.
- Recurrence rates for urinary tract stones range from 3-8%.
Implications:
- Early diagnosis and treatment of pediatric urinary concretions are crucial.
- Maintaining sterile urine for three months post-intervention minimizes recurrence risk.
- This case highlights the youngest patient with this condition, expanding the understanding of pediatric urolithiasis demographics.
Abstract:
Urinary concretions, particularly in the upper urinary tract, occur in otherwise healthy children in connection with Bacillus Proteus urinary infections. In other European countries, this occurs in 40-70% while, on the other hand, it is particularly rare in Scandinavia. A case of obstructing pelvic concretion in a boy aged three months is presented. This is the youngest case which could be found in the literature. Pyelolithotomy was performed and the child has been free from recurrence for six years. At the commencement of the disease, pain due to renal calculi may be misinterpreted as being due to three-months intestinal colic. Formation of calculi is presumed to be due the ability of Bacillus Proteus to form urease. The frequency of recurrences is 3-8% and is lowest if the urine can be maintained sterile for the first three months after removal of the stone.