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Acute Focal Bacterial Nephritis in a Patient with Solitary Kidney: Case Report

Adnane Guella1, Rabab Zaka Muhammad1, Mahdi Aljallabi2

  • 1University Hospital, Department of Internal Medicine, Sharjah, United Arab Emirates.

Clinical Practice and Cases in Emergency Medicine
|August 18, 2023
PubMed
Abstract

Insights

Acute focal bacterial nephritis, often mistaken for acute pyelonephritis, requires prompt diagnosis. Contrast-enhanced CT is key, and at least three weeks of antibiotics are crucial to prevent kidney complications, especially in solitary kidney patients.

Area of Science:

  • Nephrology
  • Radiology
  • Infectious Diseases

Background:

  • Acute focal bacterial nephritis is an underdiagnosed condition.
  • It mimics acute pyelonephritis and can lead to kidney abscesses or scars if untreated.
  • Contrast-enhanced computed tomography (CT) is the gold standard for diagnosis.

Purpose of the Study:

  • To highlight the importance of diagnosing acute focal bacterial nephritis.
  • To emphasize appropriate treatment duration for this condition.
  • To differentiate it from acute pyelonephritis in clinical practice.

Main Methods:

  • A case report of a 63-year-old male with a solitary kidney presenting with symptoms of acute pyelonephritis.
  • Initial kidney ultrasound was inconclusive.
  • Contrast-enhanced CT confirmed acute focal bacterial nephritis, followed by three weeks of IV antibiotics and a repeat CT showing improvement.

Main Results:

  • Diagnosis of acute focal bacterial nephritis was confirmed via contrast-enhanced CT.
  • The patient showed marked improvement after three weeks of intravenous antibiotics.
  • A fourth week of antibiotics was administered to ensure complete resolution.

Conclusions:

  • Accurate diagnosis of acute focal bacterial nephritis is vital, particularly in patients with a solitary kidney.
  • Treatment requires a minimum of three weeks of antibiotics to prevent complications.
  • This differs from acute pyelonephritis, necessitating a distinct therapeutic approach.

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