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2016 ; 16
(1
): 189
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Clinical assessment of children with renal abscesses presenting to the pediatric
emergency department
#MMPMID27876028
Chen CY
; Kuo HT
; Chang YJ
; Wu KH
; Yang WC
; Wu HP
BMC Pediatr
2016[Nov]; 16
(1
): 189
PMID27876028
show ga
BACKGROUND: Renal abscesses are relatively uncommon in children but may result in
prolonged hospital stays and life-threatening events. We undertook this study to
analyze the clinical spectrum of renal abscesses in children admitted to the
pediatric emergency department (ED) and to find helpful clinical characteristics
that can potentially aid emergency physicians for detecting renal abscesses in
children earlier. METHODS: From 2004 to 2011, we retrospectively analyzed 17
patients, aged 18 years or younger, with a definite diagnosis of renal abscess
admitted to the ED. The following clinical information was studied: demographics,
clinical presentation, laboratory testing, microbiology, imaging studies,
treatment modalities, complications, and long-term outcomes. We analyzed these
variables among other potential predisposing factors. RESULTS: During the 8-year
study period, 17 patients (7 males and 10 females; mean age, 6.1?±?4.5 years)
were diagnosed with renal abscesses on the basis of ultrasonography and computed
tomography findings. The 2 most common presenting symptoms were fever and flank
pain (100% and 70.6%, respectively). All of the patients presented with
leukocytosis and elevated C-reactive protein (CRP) levels. Organisms cultured
from urine or from the abscess were identified in 11 (64.7%) patients, and
Escherichia coli was the most common organism cultured. All patients were treated
with broad-spectrum intravenous antibiotics with the exception of 4 children who
also required additional percutaneous drainage of the abscess. CONCLUSIONS: Renal
abscesses are relatively rare in children. We suggest that primary care
physicians should keep this disease in mind especially when children present with
triad symptoms (fever, nausea/vomiting, and flank pain), pyuria, significant
leukocytosis, and elevated CRP levels. However, aggressive percutaneous drainage
may not need to be routinely performed in children with renal abscesses.