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Renal abscess in children.
B T Steele1, C Petrou, J de Maria
1Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ontario.
Urology
|October 1, 1990
Summary
Pediatric renal abscesses often present with fever and loin pain, but urinalysis is frequently normal. Escherichia coli and Staphylococcus aureus were the most common pathogens, with treatment often requiring surgery.
Area of Science:
- Pediatric Nephrology
- Pediatric Infectious Diseases
- Pediatric Urology
Background:
- Renal abscesses in children are uncommon but serious infections.
- Understanding their varied presentations is crucial for timely diagnosis and treatment.
Observation:
- A review of 26 pediatric cases revealed common symptoms like fever, loin pain, and leukocytosis.
- Notably, less than half of cases showed abnormal urinalysis or positive urine culture.
- Presenting symptoms could mimic other conditions such as appendicitis, peritonitis, or Wilms tumor.
Findings:
- Escherichia coli (9 cases) and Staphylococcus aureus (8 cases) were the most frequently identified pathogens.
- E. coli infections were more common in girls, while S. aureus infections were more prevalent in boys.
- Antibiotic therapy alone was successful in 38% of cases, with 62% requiring surgical intervention.
Implications:
- The study highlights the diagnostic challenges posed by atypical presentations of pediatric renal abscesses.
- It underscores the importance of considering renal abscess in children with unexplained fever and abdominal/flank pain, even with normal urine tests.
- Effective management requires a combination of appropriate antibiotic therapy and, often, surgical drainage.