小儿肾脓肿-诊断和处理的挑战:病例报告

A. Santos, Maria Andrade, Eduardo Hatanaka
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引用次数: 0

摘要

目的:探讨小儿肾脓肿的诊断难点,提醒儿科注意尿路感染可能引起的并发症。病例描述:一名患有自闭症谱系障碍和杜氏肌营养不良症的16岁男孩,尽管使用抗生素治疗尿路感染,但仍在急诊室出现持续发烧。虽然有白细胞尿,但尿培养为阴性。尿路超声检查未见明显异常。计算机断层扫描显示右肾多发肾脓肿。超声引导下穿刺。培养的液体导致ESBL肺炎克雷伯菌的生长。术后21天静脉注射抗生素导致症状和体征完全消失。评论:肾脓肿在儿童中是一种罕见的疾病。然而,在长时间发烧和当有不利的尿路感染发展时,主要是在反复发作时,必须考虑到鉴别诊断。这种疾病的早期诊断对于适当的治疗和减少并发症至关重要。
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Abscesso renal em pediatria - desafios para o diagnóstico e manejo: relato de caso
Objective: To discuss the diagnostic difficulties of renal abscess in the pediatric age and warn pediatrics about the possible complications of urinary tract infections. Case description: A 16-year-old boy with autism spectre disorder and Duchenne muscular dystrophy presented at the emergency care unit with persistent fever despite the use of antibiotics to treat an urinary tract infection. Although there was leukocyturia, the urine culture was negative. Ultrassound of the urinary tract showed no significant findings. Computed tomography showed multiple renal abscesses in the right kidney. A puncture guided by ultrasound was performed. The culture of the liquid resulted in growth of ESBL Klebsiella pneumoniae. A 21 day course of intravenous antibiotic after the procedure resulted in complete resolution of signs and symptoms. Comments: Renal abscess is a rare condition in the pediatric population. However, it must be considered in the differential diagnosis of prolonged fever and when there is a nonfavorable evolution of urinary tract infection, mainly in recurrent episodes. The early diagnosis of this condition is essential for the adequate treatment and reduction of complications.
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