Sun Jianxin, Shi Lina, Ye Lezhen, Xu Yanan
Department of Paediatrician, Women's and Children's Hospital of Ningbo University, Ningbo, China.
Department of Paediatrician, Yuyao Maternal and Child Health Centre, Yuyao, China.
Front Pediatr. 2025 Apr 28;13:1407437. doi: 10.3389/fped.2025.1407437. eCollection 2025.
Pediatric renal abscesses is a severe infectious disease with a long treatment period. Due to atypical symptoms, there is a risk of delayed diagnosis, missed diagnosis, and misdiagnosis. Inadequate or incomplete treatment can lead to prolonged hospital stays, even Irreversible kidney damage. This study aimed to analyze the clinical characteristics of pediatric renal abscesses, aiming for early diagnosis and timely, appropriate treatment.
A retrospective analysis was conducted on clinical manifestations, laboratory tests, imaging studies, and treatment data of 12 pediatric renal abscess cases treated in the Nephrology Department of our hospital from October 2018 to March 2023.
Among the 12 cases, there were 3 males and 9 females, aged between 7 months to 12 years. All cases were from urban areas, with fever being the primary symptom (100%), accompanied in some by abdominal pain and urinary frequency/pain. Clinical symptoms were atypical, with 91% showing elevated white blood cell count(WBC), a significant rise in neutrophil percentage, C-reactive protein (CRP), and a marked increase in procalcitonin (100%). significant elevation of urinary white blood cells in 83.3% of cases. Both urine and blood cultures were negative. All 12 cases underwent abdominal CT or Magnetic Resonance Urography (MRU), showing abscesses, all less than 3 cm. Treatment included third-generation cephalosporins, with the addition of linezolid in cases where the initial treatment was ineffective. Hospital stays ranged from 10 to 21 days. Follow-up MRU showed the disappearance of abscesses.
Clinical symptoms of pediatric renal abscesses are atypical. Children with fever, accompanied by abdominal pain, and significant elevation in white blood cells, CRP, and PCT should be considered for renal abscess, and abdominal CT or MRU is recommended for early diagnosis. Conservative anti-infection treatment can yield good results for abscesses smaller than 3 cm.
小儿肾脓肿是一种严重的感染性疾病，治疗周期长。由于症状不典型，存在诊断延迟、漏诊和误诊的风险。治疗不充分或不完全可导致住院时间延长，甚至造成不可逆的肾损害。本研究旨在分析小儿肾脓肿的临床特征，以期早期诊断并及时进行恰当治疗。
对2018年10月至2023年3月在我院肾内科治疗的12例小儿肾脓肿病例的临床表现、实验室检查、影像学检查及治疗资料进行回顾性分析。
12例病例中，男3例，女9例，年龄7个月至12岁。所有病例均来自市区，主要症状为发热（100%），部分伴有腹痛及尿频/尿痛。临床症状不典型，91%白细胞计数（WBC）升高，中性粒细胞百分比、C反应蛋白（CRP）显著升高，降钙素原明显升高（100%）。83.3%的病例尿白细胞显著升高。血培养和尿培养均为阴性。12例均行腹部CT或磁共振尿路造影（MRU）检查，均显示有脓肿，均小于3 cm。治疗包括使用第三代头孢菌素，初始治疗无效时加用利奈唑胺。住院时间为10至21天。随访MRU显示脓肿消失。
小儿肾脓肿临床症状不典型。对于发热伴腹痛且白细胞、CRP及PCT显著升高的患儿应考虑肾脓肿，建议行腹部CT或MRU检查以早期诊断。对于小于3 cm的脓肿，保守抗感染治疗可取得良好效果。
