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Recurrent Staphylococcus aureus renal abscess in a child positive for the human immunodeficiency virus
J M Brandeis1, L S Baskin, B A Kogan
1Department of Urology, University of California School of Medicine, San Francisco 94143-0738, USA.
Insights
A young girl with human immunodeficiency virus (HIV) developed a severe Staphylococcus aureus kidney abscess. Aggressive surgical intervention is recommended for immunocompromised patients to prevent recurrence and reduce complications.
Area of Science:
- Nephrology
- Infectious Diseases
- Immunocompromised Host Management
Background:
- Human immunodeficiency virus (HIV) infection compromises the immune system, increasing susceptibility to severe bacterial infections.
- Staphylococcus aureus is a common pathogen capable of causing serious localized infections, such as renal abscesses.
Observation:
- A 10-year-old immunocompromised female patient presented with a Staphylococcus aureus renal abscess with perinephric extension.
- Initial treatment involved percutaneous and surgical drainage, followed by a 6-week course of intravenous antibiotics.
Findings:
- Despite aggressive initial management, the renal abscess recurred three months later.
- The recurrence necessitated a nephrectomy (kidney removal) to manage the persistent infection.
Implications:
- The case highlights the challenges in eradicating Staphylococcus aureus infections in immunocompromised individuals.
- Early and aggressive surgical management, in addition to antibiotics, may be crucial for effectively treating renal abscesses in patients with compromised immunity.
- This approach could potentially reduce morbidity and prevent the need for more extensive procedures like nephrectomy.
Abstract:
A 10-year-old girl with the human immunodeficiency virus was found to have a Staphylococcus aureus renal abscess with perinephric extension. The abscess was drained first percutaneously and then surgically, and the patient received a 6-week course of intravenous antibiotics. Three months later, the abscess recurred, necessitating a nephrectomy. The extended morbidity and difficulty of eradicating S aureus suggest that, in immunocompromised patients, early aggressive surgical management is indicated.