Horigome Akihisa, Uryu Hideko, Takasago Satoshi, Atsumi Yukari, Mochizuki Shinji
Department of Pediatrics, Center Hospital of the National Center for Global Health and Medicine, Shinjuku, JPN.
Department of Cardiology, St. Luke's International Hospital, Chūō, JPN.
Cureus. 2024 Dec 5;16(12):e75191. doi: 10.7759/cureus.75191. eCollection 2024 Dec.
Coagulase-negative (CoNS) is a rare cause of UTIs in children and is often regarded as a contaminant in urine samples. We report a case of acute focal bacterial nephritis (AFBN) and bacteremia caused by following an upper respiratory infection in a pediatric patient. The patient, a four-year-old girl, presented with fever, cough, and a runny nose two days before being referred to our hospital due to persistent fever and poor oral intake. A multiplex nested PCR test of a nasopharyngeal swab sample detected human rhinovirus/enterovirus. Urinalysis showed no leukocyte esterase or nitrites, but revealed 1-4 white blood cells/high-power field and 1+ bacteria. Despite these findings, was isolated from both urine and blood cultures. Contrast-enhanced abdominal CT revealed multifocal hypodense, wedge-shaped space-occupying lesions in both kidneys, characteristic of AFBN. This case underscores that can cause severe UTIs and highlights the importance of considering CoNS, including , as a potential UTI pathogen. The results of urine cultures should be interpreted in conjunction with other clinical findings, even when an alternative diagnosis for fever is present.
凝固酶阴性(CoNS)是儿童尿路感染的罕见病因,常被视为尿液样本中的污染物。我们报告一例儿科患者上呼吸道感染后发生的急性局灶性细菌性肾炎(AFBN)和菌血症病例。该患者为一名4岁女孩,在因持续发热和口服摄入不良被转诊至我院前两天出现发热、咳嗽和流鼻涕症状。对鼻咽拭子样本进行的多重巢式PCR检测发现了人鼻病毒/肠道病毒。尿液分析未显示白细胞酯酶或亚硝酸盐,但每高倍视野有1 - 4个白细胞和1+细菌。尽管有这些发现,[具体细菌名称未给出]仍从尿液和血培养中分离出来。增强腹部CT显示双肾多发局灶性低密度、楔形占位性病变,这是AFBN的特征。该病例强调[具体细菌名称未给出]可导致严重尿路感染,并突出了将包括[具体细菌名称未给出]在内的CoNS视为潜在尿路感染病原体的重要性。即使存在发热的替代诊断,尿液培养结果也应结合其他临床发现进行解读。