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Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
06:09

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Escherichia coli cellulitis in children with idiopathic nephrotic syndrome

B I Asmar1, B N Bashour, L E Fleischmann

  • 1Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI 48201.

Clinical Pediatrics
|November 1, 1987
PubMed

Insights

Infections in children with nephrotic syndrome are shifting from Streptococcus pneumoniae to gram-negative bacteria like Escherichia coli. Early broad-spectrum antibiotics are crucial for treating infections in these vulnerable patients.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Bacteriology

Background:

  • Nephrotic syndrome in children presents a high risk for bacterial infections.
  • Streptococcus pneumoniae has historically been the most common pathogen.
  • Emerging trends indicate a rise in infections caused by encapsulated gram-negative organisms.

Observation:

  • Two pediatric cases of idiopathic nephrotic syndrome in relapse are presented.
  • Both patients developed spontaneous Escherichia coli cellulitis.
  • Escherichia coli was identified in cellulitis aspirate and blood cultures.

Findings:

  • Escherichia coli can cause spontaneous cellulitis in children with nephrotic syndrome.
  • Prompt and appropriate antibiotic therapy led to positive patient outcomes.
  • The study highlights a potential shift in causative pathogens for infections in this population.

Implications:

  • Clinical management of nephrotic syndrome patients with infections should consider gram-negative pathogens.
  • Broad-spectrum antibiotic coverage is recommended for suspected sepsis, peritonitis, or cellulitis pending culture results.
  • This underscores the need for updated guidelines on empirical antibiotic treatment in pediatric nephrotic syndrome.

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