García-Penit F J, Monreal García de Vicuña F, Collado Serra A, Gausa Gascón L, Montlleó M
Servicio de Urología, Fundación Puigvert, Barcelona, España.
Arch Esp Urol. 2001 Jan-Feb;54(1):66-9.
To report a case of acute lobar nephronia, an unusual form of localized renal infection, and review the literature with special reference to the clinical features, ultrasound and CT findings that distinguish this condition from other renal masses (abscess, infected cyst and renal carcinoma).
METHODS/RESULTS: A female patient presented at the emergency services with symptoms and signs compatible with pyelonephritis. An admission abdominal ultrasound scan demonstrated a solid mass in the left inferior renal pole. CT showed a renal mass with peripheral enhancement after infusion of contrast and central striation. Blood and urine analyses were compatible with renal infection. Acute lobar nephronia was suspected and antibiotic treatment was administered. Control ultrasound and CT examinations performed one month after instituting antibiotic treatment showed the mass had disappeared.
Acute lobar nephronia should be considered in all patients with a renal mass detected during an episode of urinary infection. Correlation of the clinical and radiological findings, and resolution of the mass with appropriate antibiotic therapy will confirm the diagnosis.
报告一例急性大叶性肾肾炎(一种罕见的局限性肾脏感染形式),并特别参照将该病症与其他肾脏肿块(脓肿、感染性囊肿和肾癌)相鉴别的临床特征、超声及CT表现对文献进行综述。
方法/结果:一名女性患者因与肾盂肾炎相符的症状和体征前往急诊。入院时腹部超声扫描显示左肾下极有一实性肿块。CT显示注入造影剂后肾肿块周边强化且中央有条纹状改变。血液和尿液分析与肾脏感染相符。怀疑为急性大叶性肾肾炎并给予抗生素治疗。在开始抗生素治疗一个月后进行的对照超声和CT检查显示肿块已消失。
对于在尿路感染发作期间检测到肾脏肿块的所有患者,均应考虑急性大叶性肾肾炎。临床和影像学表现的相关性以及肿块经适当抗生素治疗后消退将证实诊断。