Renal abscess in children

Ten children with renal abscesses treated during the last 25 years are reviewed following our recent experience with 3 children, each of whom presented with an abscess. The diagnosis was not readily apparent before hospitalization, despite characteristic features of the disease. Excretory urography with nephrotomography proved to be the most valuable diagnostic study. Angiography was useful in differentiating the abscess from other intrarenal processes. Staphylococcus aureus was the most common infecting organism. Upper urinary tract anomalies were noted most frequently with gram-negative infections. Treatment consisted of drainage of the abscess in 8 children. Nephrectomy was required in 2 girls, each of whom had multiple extensive gram-negative carbuncles. The pathogenesis and therapy of a renal abscess are discussed.