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2017 ; 17
(1
): 240
Nephropedia Template TP
gab.com Text
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English Wikipedia
Acute focal bacterial nephritis is associated with invasive diagnostic procedures
- a cohort of 138 cases extracted through a systematic review
#MMPMID28376724
Sieger N
; Kyriazis I
; Schaudinn A
; Kallidonis P
; Neuhaus J
; Liatsikos EN
; Ganzer R
; Stolzenburg JU
BMC Infect Dis
2017[Apr]; 17
(1
): 240
PMID28376724
show ga
BACKGROUND: Acute focal bacterial nephritis (AFBN) is a rare disease currently
described only in case reports and small case series. In this study we summarize
the clinical features of AFBN as has been documented in the literature and draw
recommendations on the proper diagnosis and therapy. METHODS: A systematic
literature review was undertaken in PUBMED, Web of Science and The Cochrane
Library online databases for relevant literature on AFBN in adults. RESULTS:
Literature review revealed a total of 38 articles according to our inclusion
criteria, of which we could extract data from 138 cases of AFBN. Fever (98%) and
flank pain (80%) were most commonly reported symptoms. E. coli was the most
frequent pathogen. Diagnosis was set by CT and/or MRI (52%) with or without
sonography or by sonography alone (20%) as well as by sonography combined with
IVU. In total, sonography was applied in 83% of cases. All but one patient
received antibiotic treatment. Kidney lesions were occasionally mistaken for
neoplasms or renal abscesses and as a result, cases were subjected to
percutaneous puncture (12.3%), surgical exploration (5.1%) and partial or radical
nephrectomy (4.4%). Four cases (2.9%) developed a renal abscess. CONCLUSIONS: The
diagnosis of AFBN is set by characteristic clinico-radiological findings.
Differential diagnoses of this interstitial bacterial infection include renal
abscess and tumor. Correct diagnosis is occasionally impeded by atypical
symptoms. Invasive diagnostic and therapeutic procedures should be limited as the
majority of cases respond well to conservative treatment.