ABSTRACT
Xanthogranulomatous pyelonephritis (XGPN) is an unusual suppurative granulomatous reaction to chronic renal infection, often in the presence of chronic obstruction, characterised histologically by granulomatous reaction with giant cells and foamy histiocytes1. XGPN is rare in children2. We report a case of XGPN, in a child with multiple lower ureteric calculi. An 11 year old male child presented to us, with features suggestive of acute pyelonephritis of two months duration.complete evaluation including contrast CT of the abdomen a diagnosis of XGPN was made. As the renal unit in question was non functional, he was treated successfully by subcapsular nephrectomy. This case is presented to emphasise the fact that, it is very important to diagnose XGPN early and differentiate it from chronic pyelonephritis. Prolonged antibiotic therapy and surgery is invariably required to relieve the obstruction and to eradicate the infection in patients with XGPN.
Subject(s)
Child , Humans , Male , Nephrectomy/methods , Pyelonephritis, Xanthogranulomatous/drug therapy , Pyelonephritis, Xanthogranulomatous/epidemiology , Pyelonephritis, Xanthogranulomatous/surgery , Ureteral Calculi/complications , Ureteral Calculi/drug therapy , Ureteral Calculi/epidemiology , Ureteral Calculi/surgeryABSTRACT
Focal xanthogranulomatous pyelonephritis is an atypical form of chronic renal infection, It is frequently misdiagnosed preoperatively because of its resemblance to malignancy. We report on a fifty years old woman who presented with a right kidney mass. The CT scan showed a solid aspect mass with a lithiasis of the upper ureter. The diagnosis of local xanthogranulomatous pyelonephritis was suspected by clinical and radiological findings and confirmed by histopathologic examination of percutaneous biopsy specimens of the lesion. Successful treatement of the patient was achieved with leaving on the lithiasis and antibiotic therapy dosing eight weeks. Three months later the CT scan was completely normal. The conservative treatment of focal xanthogranulomatous pyelonephritis makes possible to avoid a needless nephrectomy usually on young patients. However a close follow-up must be undergone on these patients because of the possible association of focal xanthogranulomatous pyelonephritis and renal cell carcinoma of the kidney
Subject(s)
Humans , Female , Pyelonephritis, Xanthogranulomatous/drug therapy , Kidney/pathology , Tomography, X-Ray Computed , Anti-Bacterial AgentsABSTRACT
La pielonefritis xantogranulomatosa (PX) es una rara infección crónica y severa del parénquima renal. Debido a que sus manifestaciones simulan una neoplasia, el diagnóstico preoperatorio es dificultoso. Habitualmente se asocia a infección bacteriana monomicrobiana. Nosotros comunicamos el caso de PX asociada a infección polimicrobiana, una de las cuales es un microorganismo anaeróbico