Ferrer F A, Herndon C D, McKenna P H
Department of Pediatric Urology, Connecticut Children's Medical Center, Hartford, Connecticut 06106, USA.
Urology. 1999 Dec;54(6):1097. doi: 10.1016/s0090-4295(99)00360-x.
One percent of all pregnancies are found to have an antenatal abnormality; of these, 20% involve the genitourinary system. Today, controversy still exists regarding the postnatal management of some antenatal abnormalities detected by ultrasound. We present a case in which antenatal hydronephrosis initially detected by ultrasound appeared to resolve in utero. Postnatally, the child developed Citrobacter diversus urosepsis, meningitis, and cerebral abscess. Voiding cystourethrogram obtained after resolution of sepsis revealed grade IV reflux. This case underscores the importance of a full postnatal evaluation for all children with antenatal hydronephrosis and alerts clinicians to a virulent pathogen not commonly associated with urinary tract infection.
所有妊娠中有1%被发现存在产前异常；其中，20%涉及泌尿生殖系统。如今，对于超声检测出的一些产前异常的产后管理仍存在争议。我们报告一例病例，最初经超声检测出的产前肾积水在子宫内似乎有所缓解。出生后，该患儿发生了奇异柠檬酸杆菌泌尿道感染、脑膜炎和脑脓肿。败血症消退后进行的排尿性膀胱尿道造影显示为IV级反流。本病例强调了对所有产前肾积水患儿进行全面产后评估的重要性，并提醒临床医生注意一种通常与尿路感染无关的致命病原体。
