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[儿童肾盂肾炎伴肾脓肿]

[Pyelonephritis with renal abscess in a child].

作者信息

Bast Bertine C, Brand Madelon E

机构信息

Westfriesgasthuis, Hoorn, The Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2011;155(18):A3120.

Abstract

BACKGROUND

Pyelonephritis is a rare condition. It can sometimes be complicated by a renal abscess.

CASE DESCRIPTION

A 7-year-old girl had a complicated course of a pyelonephritis. She was being administered intravenous antimicrobial agents and developed a fever with cold chills during treatment. Ultrasound and MRI revealed that the cause of the deterioration was a renal abscess. The patient was treated with ceftriaxone en gentamicin. Escherichia coli was isolated from the abscess. After two weeks of treatment, an MRI showed that the renal abscess had almost disappeared; this was confirmed by an additional ultrasound one week after the treatment had been discontinued.

CONCLUSION

The symptoms of a renal abscess are high fever, cold chills, stomach pain, groin pain, weight loss, total malaise, and clinical deterioration whilst under treatment. Quick recognition of the condition is important. An abscess of less than 5 cm in diameter may be treated with antibiotics alone.

摘要

背景

肾盂肾炎是一种罕见病症。它有时会并发肾脓肿。

病例描述

一名7岁女孩患了复杂性肾盂肾炎。她正在接受静脉抗菌药物治疗,治疗期间出现发热伴寒战。超声和磁共振成像显示病情恶化的原因是肾脓肿。患者接受头孢曲松加庆大霉素治疗。从脓肿中分离出大肠杆菌。治疗两周后,磁共振成像显示肾脓肿几乎消失;治疗停止一周后进行的额外超声检查证实了这一点。

结论

肾脓肿的症状包括高热、寒战、胃痛、腹股沟疼痛、体重减轻、全身不适以及治疗期间临床病情恶化。快速识别这种病症很重要。直径小于5厘米的脓肿可单独用抗生素治疗。

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