Original ArticleIs Acute Lobar Nephronia the Midpoint in the Spectrum of Upper Urinary Tract Infections between Acute Pyelonephritis and Renal Abscess?
Section snippets
Methods
This study was approved by our institutional review board, and informed consent was not required. We retrospectively evaluated the medical records of children hospitalized with the discharge diagnosis of UTI at Chang Gang Children's Hospital between January 2006 and December 2007. On the basis of our previously published systematic diagnostic scheme,6 the patients included in this study were those who presented with a febrile UTI who underwent ultrasonographic and CT evaluation to confirm the
Results
In total, 115 patients (21 with APN, 85 with ALN, and 9 with renal abscesses) were included in the study. Of those with APN, 3 had nephromegaly and 18 did not. Only 6 had minimally focal CT lesions similar to simple ALN findings. Of the patients with ALN, 63 had simple ALN (20 right ALN, 23 left ALN, and 20 bilateral ALN), and 22 had complicated ALN (10 right ALN, 8 left ALN, and 4 bilateral ALN). All of the patients with renal abscesses had associated findings of complicated ALN elsewhere in
Discussion
Instead of the characteristic appearance of a focal mass in the kidney with ill-defined margins, the hallmark of the ultrasonographic findings of ALN,3, 10, 11 which unfortunately has a low sensitivity for diagnosis,5, 6, 12 we proposed a systematic imaging evaluation scheme for detecting ALN in patients with febrile UTI. Our scheme combines renal ultrasonography and CT.6 We identified more children with ALN, for an incidence of 8.6% in pediatric patients with febrile UTI.5 Indeed, ALN is not
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Cited by (0)
The authors declare no conflicts of interest.