Renal abscess in childhood.

Eight patients with renal abscess were seen in a 15-year period. The patients' ages ranged from 3 to 15 years with a mean of 6.5 years. Included were 7 female children, five of whom were Aboriginal, and 1 male child. Clinical presentation ranged from localized renal symptoms to a generalized septicaemic illness. Ultrasonography proved to be the most useful diagnostic investigation. Surgical management consisted of open surgical drainage in 5 cases with secondary nephrectomy in one. Two recent cases were managed by percutaneous drainage of the abscess together with appropriate antibiotic therapy. One case was successfully managed by antibiotic therapy without surgical or radiological intervention. In 5 cases the infecting organism was penicillinase-producing Staphylococcus aureus and, in 2 cases, Escherichia coli was isolated. It is concluded that the diagnosis of renal abscess should be considered in patients with a febrile septicaemic illness, particularly in Aboriginal female children. Ultrasonography is recommended as the investigation of choice which can also be used to establish percutaneous drainage, thus avoiding surgery.