Renal abscess and nephronia are uncommon diseases in children and with unknown global prevalence. Nephronia represents an intermediate state between pyelonephritis and renal abscess. Prompt diagnosis is important to p...Renal abscess and nephronia are uncommon diseases in children and with unknown global prevalence. Nephronia represents an intermediate state between pyelonephritis and renal abscess. Prompt diagnosis is important to prevent morbidity and mortality (sepsis, renal injury, death). Scientific advances have made these entities more evident, although they may still be underdiagnosed. Patients with this disease require prolonged intravenous antibiotic therapy and potentially surgical resolution, mostly when their size is bigger than 3 - 5 cm when therapy with intravenous antibiotics alone fails and they are accessible to percutaneous drainage. We describe five cases of pediatric patients from four private hospitals in Quito, Ecuador followed during a one-year period. In every case, the diagnosis was suspected mostly because of persistent fever, abdominal pain, severe leukocytosis and/or elevated inflammation biomarkers. Only one of them had a previous history of urinary tract malformation while in another one malformation was revealed in his actual admission. Every case had microbiologic isolation. All of them recovered successfully. To our knowledge, in our country, there are no previous reports of these diseases in pediatric patients, and worldwide, there is scarce data. Our aim is to alert doctors who work with children to be aware of this condition.展开更多
Reactive thrombocytosis can be seen in patients with various kinds of infections, including upper urinary tract infection. Thrombocytosis in patients with upper urinary tract infection is a response of the bone marrow...Reactive thrombocytosis can be seen in patients with various kinds of infections, including upper urinary tract infection. Thrombocytosis in patients with upper urinary tract infection is a response of the bone marrow to the infection and is therefore classified as secondary thrombocytosis. We report a case of thrombocytosis accompanying renal abscess. In this case report, we present that thrombocytosis in a patient with upper urinary tract infection is not a random condition and is associated with renal abscess which is a complication of disease.展开更多
Background: Crizotinib is a tyrosine kinase inhibitor of ALK, MET and ROS1. In a safety database trial, it was suggested an association of Crizotinib with the development of renal cyst in patients with non-small-cell ...Background: Crizotinib is a tyrosine kinase inhibitor of ALK, MET and ROS1. In a safety database trial, it was suggested an association of Crizotinib with the development of renal cyst in patients with non-small-cell lung cancer (NSCLC). Aim: To report an uncommon side effect of Crizotinib in a patient with NSLC. Case Presentation: We report the case of a 68-year-old woman with NSCLC who developed bilateral progressive aseptic renal abscesses during Crizotinib treatment. Conclusion: Further studies may be necessary to determinate the risk of renal cyst development and the management of these complications.展开更多
AIM： To elucidate the clinical, radiological and laboratory pro？les of renal abscess （RA） and perinephric abscess （PNA）, along with related treatment and outcome.METHODS： Ninety-eight patients diagnosed with RA...AIM： To elucidate the clinical, radiological and laboratory pro？les of renal abscess （RA） and perinephric abscess （PNA）, along with related treatment and outcome.METHODS： Ninety-eight patients diagnosed with RA or PNA using the primary discharge diagnoses identi？ed from the International Statistical Classification of Diseases and Related Health Problems Tenth Edition （ICD-10） codes （RA： N15.101, PNA： N15.102） between September 2004 and December 2014 in West China Hospital were selected. Medical records including patients’ characteristics, symptoms and signs, high-risk factors, radiological features, causative microorganisms and antibiotic-resistance pro？les, treatment approaches, and clinical outcomes were collected and analyzed.RESULTS： The mean age of the patients was 46.49 years with a male to female ratio of 41：57. Lumbar pain （76.5%） and fever （53.1%） were the most common symptoms. Other symptoms and signs included chills （28.6%）, anorexia and vomiting （25.5%）, lethargy （10.2%）, abdominal pain （11.2%）, fank mass （12.2%）, fank ？stula （2.0%）, gross hematuria （7.1%）, frequency （14.3%）, dysuria （9.2%）, pyuria （5.1%） and weight loss （1.0%）. Painful percussion of the costovertebral angle （87.8%） was the most common physical ？nding. The main predisposing factors were lithiasis （48.0%）, diabetes mellitus （33.7%） followed by history of urological surgery （16.3%）, urinary tract infections （14.3%）, renal function impairment （13.3%）, liver cirrhosis （2.0%）, neurogenic bladder （1.0%）, renal cyst （1.0%）, hydronephrosis （1.0%）, chronic hepatitis B （1.0%）, post-discectomy （1.0%） and post-colectomy （1.0%）. Ultrasound （US） and computed tomography were the most valuable diagnostic tools and US was recommended as the initial diagnostic imaging choice.Escherichia coli （51.4%）, Staphylococcus aureus （10.0%） and Klebsiella pneumoniae （8.6%） were the main causative microorganisms. Intravenous antibiotic therapy was necessary while intervention including surgical and nonsurgical approaches were reserved for larger abscesses, multiple abscesses, PNAs and non-responders. CONCLUSION： Heightened alertness, prompt diagnosis, and especially proper antibiotics in conjunction with interventional approaches allow a promising clinical outcome of renal and perinephric abscesses.展开更多
文摘Renal abscess and nephronia are uncommon diseases in children and with unknown global prevalence. Nephronia represents an intermediate state between pyelonephritis and renal abscess. Prompt diagnosis is important to prevent morbidity and mortality (sepsis, renal injury, death). Scientific advances have made these entities more evident, although they may still be underdiagnosed. Patients with this disease require prolonged intravenous antibiotic therapy and potentially surgical resolution, mostly when their size is bigger than 3 - 5 cm when therapy with intravenous antibiotics alone fails and they are accessible to percutaneous drainage. We describe five cases of pediatric patients from four private hospitals in Quito, Ecuador followed during a one-year period. In every case, the diagnosis was suspected mostly because of persistent fever, abdominal pain, severe leukocytosis and/or elevated inflammation biomarkers. Only one of them had a previous history of urinary tract malformation while in another one malformation was revealed in his actual admission. Every case had microbiologic isolation. All of them recovered successfully. To our knowledge, in our country, there are no previous reports of these diseases in pediatric patients, and worldwide, there is scarce data. Our aim is to alert doctors who work with children to be aware of this condition.
文摘Reactive thrombocytosis can be seen in patients with various kinds of infections, including upper urinary tract infection. Thrombocytosis in patients with upper urinary tract infection is a response of the bone marrow to the infection and is therefore classified as secondary thrombocytosis. We report a case of thrombocytosis accompanying renal abscess. In this case report, we present that thrombocytosis in a patient with upper urinary tract infection is not a random condition and is associated with renal abscess which is a complication of disease.
文摘Background: Crizotinib is a tyrosine kinase inhibitor of ALK, MET and ROS1. In a safety database trial, it was suggested an association of Crizotinib with the development of renal cyst in patients with non-small-cell lung cancer (NSCLC). Aim: To report an uncommon side effect of Crizotinib in a patient with NSLC. Case Presentation: We report the case of a 68-year-old woman with NSCLC who developed bilateral progressive aseptic renal abscesses during Crizotinib treatment. Conclusion: Further studies may be necessary to determinate the risk of renal cyst development and the management of these complications.
文摘AIM： To elucidate the clinical, radiological and laboratory pro？les of renal abscess （RA） and perinephric abscess （PNA）, along with related treatment and outcome.METHODS： Ninety-eight patients diagnosed with RA or PNA using the primary discharge diagnoses identi？ed from the International Statistical Classification of Diseases and Related Health Problems Tenth Edition （ICD-10） codes （RA： N15.101, PNA： N15.102） between September 2004 and December 2014 in West China Hospital were selected. Medical records including patients’ characteristics, symptoms and signs, high-risk factors, radiological features, causative microorganisms and antibiotic-resistance pro？les, treatment approaches, and clinical outcomes were collected and analyzed.RESULTS： The mean age of the patients was 46.49 years with a male to female ratio of 41：57. Lumbar pain （76.5%） and fever （53.1%） were the most common symptoms. Other symptoms and signs included chills （28.6%）, anorexia and vomiting （25.5%）, lethargy （10.2%）, abdominal pain （11.2%）, fank mass （12.2%）, fank ？stula （2.0%）, gross hematuria （7.1%）, frequency （14.3%）, dysuria （9.2%）, pyuria （5.1%） and weight loss （1.0%）. Painful percussion of the costovertebral angle （87.8%） was the most common physical ？nding. The main predisposing factors were lithiasis （48.0%）, diabetes mellitus （33.7%） followed by history of urological surgery （16.3%）, urinary tract infections （14.3%）, renal function impairment （13.3%）, liver cirrhosis （2.0%）, neurogenic bladder （1.0%）, renal cyst （1.0%）, hydronephrosis （1.0%）, chronic hepatitis B （1.0%）, post-discectomy （1.0%） and post-colectomy （1.0%）. Ultrasound （US） and computed tomography were the most valuable diagnostic tools and US was recommended as the initial diagnostic imaging choice.Escherichia coli （51.4%）, Staphylococcus aureus （10.0%） and Klebsiella pneumoniae （8.6%） were the main causative microorganisms. Intravenous antibiotic therapy was necessary while intervention including surgical and nonsurgical approaches were reserved for larger abscesses, multiple abscesses, PNAs and non-responders. CONCLUSION： Heightened alertness, prompt diagnosis, and especially proper antibiotics in conjunction with interventional approaches allow a promising clinical outcome of renal and perinephric abscesses.
