Barker A P, Ahmed S
Department of Paediatric Surgery, Adelaide Children's Hospital, South Australia.
Aust N Z J Surg. 1991 Mar;61(3):217-21. doi: 10.1111/j.1445-2197.1991.tb07595.x.
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.
在15年期间共诊治了8例肾脓肿患者。患者年龄在3至15岁之间，平均年龄为6.5岁。其中包括7名女童，其中5名是原住民，以及1名男童。临床表现从局部肾脏症状到全身性败血症不等。超声检查被证明是最有用的诊断方法。手术治疗包括5例行开放手术引流，其中1例继发肾切除术。最近2例通过经皮脓肿引流并结合适当的抗生素治疗。1例通过抗生素治疗成功治愈，无需手术或放射介入。5例感染菌为产青霉素酶金黄色葡萄球菌，2例分离出大肠杆菌。结论是，对于发热性败血症患者，尤其是原住民女童，应考虑肾脓肿的诊断。建议首选超声检查，它还可用于建立经皮引流，从而避免手术。
