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A Clinical and Radiologic Study of Acute Focal Bacterial Nephritis in Children

Journal of the Korean Pediatric Society 2003;46(4):351-357.
Published online April 15, 2003.
A Clinical and Radiologic Study of Acute Focal Bacterial Nephritis in Children
Kum Ho Song1, Kwon Hoe Huh1, Ok Yeon Cho1, Jae Hoon Sim1, Do Jun Cho1, Dug Ha Kim1, Ki Sik Min1, Ki Yang Yoo1, Kwan Seop Lee2
1Department of Pediatrics, College of Medicine, Hallym University, Anyang, Korea
2Department of Radiology, College of Medicine, Hallym University, Anyang, Korea
소아에서의 급성 국소성 세균성 신장염의임상 및 방사선학적 고찰
송금호1, 허권희1, 조옥연1, 심재훈1, 조도준1, 김덕하1, 민기식1, 유기양1, 이관섭2
1한림대학교 의과대학 소아과학교실
2한림대학교 의과대학 진단방사과교실
Correspondence: 
Ki Sik Min, Email: kisikmin@hanmail.net
Abstract
Purpose
: To raise awareness of the clinical importance of, and the need for proper management of acute focal bacterial nephritis(AFBN), we analyzed 22 AFBN patients and 22 other upper urinary tract infection patients by use of comparative studies.
Methods
: From January 2000 to May 2002, 22 AFBN patients aged from 1 month to 12 months were selected. As a control group, 22 UTI patients with no radiologic abnormalities were selected and matched by age and sex.
Results
: The incidence of AFBN was more common in boys than in girls. Since both groups had similar symptoms, it was difficult to diagnose AFBN by clinical presentations alone. ESR and CRP were significantly higher in AFBN patients. The most common causative organism was E. coli in both groups. On the sonographic findings, the most lesions were seen on the upper lobe of the kidney; more frequently, on left kidney. The lesions showed globular or wedge-shaped increased echogenecity. 99mTc-DMSA scan showed the complete coincidence of the location, size and shape in all cases compared to the findings of renal sonography.
Conclusion
: The roles of renal sonography and DMSA scan were very important, and ultrasonography was an excellent initial tool in diagnosing AFBN. Since the degree of infection in AFBN is more severe than other urinary tract infections and evollution into a renal abscess is possible, early diagnosis and appropriate antibiotics therapy is essential.
Key Words: Acute focal bacterial nephritis(AFBN)


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