Primary neonatal MRSA pyonephrosis

Abstract

Pyonephrosis is uncommon in adult and paediatric population and very rare in neonates. Neonatal candidal and staphylococcal pyonephrosis has been reported earlier, and this is the first reported case of MRSA pyonephrosis. A case of potentially lethal fulminating primary MRSA pyonephrosis with septic shock in a neonate in whom investigations showed refluxing and obstructing left megaureter requiring successful surgical correction has been reported.

Acute focal bacterial nephritis, pyonephrosis and renal abscess in children

“…Most of the reported episodes occurred in children beyond infancy with a previous urological history. Initial presentation often mimicked other febrile conditions and resulted in diagnostic delays [5,16,18,19,22].…”

“…Antibiotic treatment for 4 weeks is required in any case [5,10]. Nephrectomy is exceptional as a treatment for pyonephrosis; however drainage is unavoidable in most cases [22]. All of our children with pyonephrosis and the one patient with renal/perirenal abscess required corrective surgery after the acute phase.…”

“…Renal abscess is better defined as a focal, walled-off purulent parenchymal cavity, but it remains a diagnostic challenge due to diverse origins of infection and different pathogenetic mechanisms among patients, such as complicating UTI arising from haematogenous spread, or staphylococcal carbuncle in rare cases of proximity to an infected area [5,10]. Information on pyonephrosis remains more scanty and is based mainly on case reports [6,22].…”