Delayed Diagnosis of Acute Pyelonephritis with Renal Abscesses in a Child with Coexisted Upper Respiratory Tract Infection

小兒急性腎盂炎腎膿瘍延遲診斷之個案：初期合併上呼吸道感染

吳建林(Chien-Lin Wu) ； 周國燊(Kuo-Shen Chow)

《台灣家庭醫學雜誌》 27卷3期 (2017/09) Pp. 183-190

https://doi.org/10.3966/168232812017092703006

摘要

Renal abscess in the pediatric population is rare, only a few cases reported in the literatures worldwide. Occasionally urinary tract infection might progress to abscess formation. Escherichia coli and Staphylococcus aureus are the most common causative pathogens. Clinical symptoms and signs are insidious and non-specific, mainly as fever and abdominal discomforts. Laboratory and microbiology examinations are not always informative for diagnosis. Delayed recognition and management of renal abscess are common and result in renal scarring and loss. Early diagnosis is imperative and is a great challenge to the clinicians. Ultrasonography and computed tomography can effectively diagnose renal abscess that can be treated with antibiotics or drainage therapy. We report a 9 year-old girl of delayed diagnosis of renal abscesses. She also had upper respiratory tract infection.

關鍵字

acute pyelonephritis ； renal abscess ； upper respiratory tract infection

並列摘要

腎膿瘍在小兒族群中相當少見，文獻中也少提及相關之研究。腎膿瘍之兒童並不總是由泌尿道感染所引起，發燒及腹部不適為腎膿瘍常見之臨床症狀。大腸桿菌(Escherichia coli)及金黃色葡萄球菌(Staphylococcus aureus)是常見之致病菌。臨床症狀和徵兆隱密且不具特異性，實驗室和微生物學檢查並不都能協助診斷，易導致延遲發現與治療，造成腎臟纖維化及腎功能喪失等併發症。早期準確診斷極其重要，為臨床醫師的一大挑戰。藉由腎臟超音波和電腦斷層掃描的檢查，可有效診斷腎膿瘍及早期給於抗生素或引流治療。在此我們報告一位9歲女性病童初期合併上呼吸道感染之症狀而導致腎膿瘍延遲診斷之個案。

並列關鍵字

急性腎盂腎炎 ； 腎膿瘍 ； 上呼吸道感染

參考文獻

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