Nefritis Aguda Focal: Caso Clínico

Sch, Francisco Cano; R, Pablo Strodthoff; A, Oscar Muñoz

doi:10.4067/s0370-41062010000300008

Cited by 3 publications

(4 citation statements)

References 13 publications

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“…Se desconocen las tasas de incidencia y prevalencia; sin embargo, se describe una frecuencia entre el 8-19 % dentro de las infecciones del tracto urinario febriles en niños (5). Su fisiopatología no está del todo esclarecida, empero, para la mayoría de los niños la patogénesis puede estar relacionada con la infección ascendente, ya que se asocia a malformaciones de la vía urinaria, especialmente el reflujo vesicoureteral (RVU), el cual es común en estos pacientes (40 %) (6). Los microorganismos relacionados son E. coli (más frecuente), Pseudomona aeruginosa, Staphylococcus aureus, entre otros (3,5).…”

Section: Discussionunclassified

Nefronía lobar aguda en el paciente pediátrico. Reporte de caso

Barragan Arévalo,

Mancera Morales,

Echeverri Restrepo

et al. 2023

Pediatria.

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Antecedentes: La nefritis focal aguda es una inflamación renal de origen bacteriano, sin licuefacción, que afecta uno o más lóbulos renales. Esta entidad es subdiagnosticada y se encuentran pocos casos descritos en la literatura. Es importante su reconocimiento por su relación con urosepsis y cicatrices renales. Puede simular un tumor renal. Se asocia a malformaciones de la vía urinaria. Las imágenes diagnósticas tienen gran valor, siendo la ecografía y la tomografía las imágenes de elección. El tratamiento consiste en antibioticoterapia, con una evolución generalmente satisfactoria. Reporte de caso: paciente masculino, de seis años, con cuadro clínico de dos semanas de fiebre diaria, sin otra sintomatología. Examen físico normal. Hemograma con leucocitosis y neutrofilia, uroanálisis normal. Ecografía abdominal lesión renal inespecífica en el polo superior izquierdo. Tomografía de abdomen contrastada mostró tumoración renal izquierda, heterogénea, de bordes mal definidos, comprometiendo la corteza renal, cápsula y espacio perirrenal, sin calcificaciones, sin colecciones, sin características claramente tumorales, sin realce con medio de contraste. Resonancia de abdomen contrastada con lesión compatible con un proceso inflamatorio. Manejo con amikacina, cefalotina y clindamicina por tres semanas, con adecuada evolución. Imágenes de control con disminución de la lesión. Conclusión: La nefritis focal aguda es una entidad poco frecuente en pediatría. Es importante su reconocimiento por su impacto en la función renal. Las imágenes de elección son la ecografía y la TAC. Se recomienda el manejo antibiótico por tres semanas, estudio de malformaciones urinarias asociadas, seguimiento ecográfico y con gammagrafía DMSA para evaluar cicatrices.

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Section: Discussionunclassified

Nefronía lobar aguda en el paciente pediátrico. Reporte de caso

Barragan Arévalo,

Mancera Morales,

Echeverri Restrepo

et al. 2023

Pediatria.

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“…(2) Escheri-chia coli (E. coli) is the most commonly isolated etiologic agent. (1,3,4) Hematogenous spread appears to be an important infection mechanism for ABN, and wedge-shaped lesions on the renal parenchyma suggest bacterial emboli dissemination. (5) ABN shares the same clinical features as acute pyelonephritis (APN) and both may present with fever, flank pain, pyuria, bacteriuria, and leukocytosis.…”

Section: Introductionmentioning

confidence: 99%

“…(5) ABN shares the same clinical features as acute pyelonephritis (APN) and both may present with fever, flank pain, pyuria, bacteriuria, and leukocytosis. (3,4,6,7) Therefore, imaging studies are needed to differentiate between ABN and APN. The main sonographic findings in ABN are hypoechoic lesions with irregular, poorly defined margins, which may be associated with nephromegaly or perinephric fluid.…”

Section: Introductionmentioning

confidence: 99%

“…(2,7,13) Acute inflammation, edema, and diffuse leukocyte infiltration are histopathologic findings in ABN, as well as in APN. (4,6,14,15) It is important to differentiate ABN from other infectious renal processes because a more aggressive and prolonged treatment is required and there is also a high risk of renal abscess progression. (15) Few case series on ABN in adults are available, but at present, greater access to imaging studies has resulted in increased awareness and diagnosis of the disease.…”

Section: Introductionmentioning

confidence: 99%

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Acute bacterial nephritis. A descriptive study of an underdiagnosed entity

Madero-Morales

Pallares-Méndez

Romero-Mata

et al. 2020

rmu

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Background: Acute bacterial nephritis is an infectious process diagnosed through imaging studies. The clinical course of the disease has been shown to be more aggressive than acute pyelonephritis. It continues to be underdiagnosed, thus there are few studies on the entity in the literature. Objective: To describe the clinical characteristics and imaging features of acute bacterial nephritis, as well as its clinical course. Design: A descriptive, retrospective case series was conducted. Materials and methods: Thirty-two cases of acute bacterial nephritis in patients admitted to the hospital within the time frame of 2009 to 2016 were reviewed. The patients’ clinical characteristics upon admission were registered, as well as inpatient clinical progression, culture results, and antibiotic therapy response. The imaging studies were re-evaluated and the diagnostic consistency with either the focal or multifocal disease presentation was confirmed. Results: Cases predominated in women (n=29, 90.62%) and the most frequently associated comorbidities were diabetes (n=16, 50%) and obesity (n=9, 28.25%). The most important clinical findings upon admission were fever (n=15, 46.87%) and leukocytosis (n=27, 84.38%). Escherichia coli was the most commonly isolated bacterium (63.63%). Both acute focal bacterial nephritis and acute multifocal bacterial nephritis were observed in 46.87% (n=15) and 53.13% (n=17) of the patients, respectively. Imaging studies were required for all diagnoses. Conclusion: Fever and leukocytosis are the main findings in acute bacterial nephritis. Imaging studies are necessary for making the diagnosis, given that acute pyelonephritis and acute bacterial nephritis cannot be clinically differentiated.

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