A Clinical Study of Renal Abscesses in Children

ABSTRACT

PURPOSE: Renal abscess is very rare in children and its diagnosis is difficult because symptoms are often nonspecific. In previous studies, only 15% to 25% of patients were reported to be diagnosed at the time of admission. Early diagnosis and treatment are important because mortality rate correlates positively with the time of diagnosis. The purpose of this study is to clarify the clinical features of children with renal abscess and to investigate the possible indicators of this disease for early diagnosis and proper treatment. METHODS: Twelve children diagnosed with renal abscess from Jan. 1996 to Jul. 2004 were included. The age of patients ranged from 5 months to 15 years. We retrospectively analyzed the demographics of patients, their symptoms, predisposing factors, diagnostic methods and causative organisms and the treatment modalities. RESULTS: Fever was the most common manifestation. Five children(42%) had vesicoureteral reflux. Renal ultrasonography and computerized tomography were the most frequently used imaging tools to detect renal abscess. Gram negative bacteria were isolated in 7 patients and Staphylococcus aureus grew in 2 patients. All patients received intravenous antibiotics and 4 patients underwent aspiration or drainage of renal abscess. The average admission duration was 30 days. CONCLUSION: Renal abscess should be included in the differential diagnosis of prolonged fever in children, especially when flank pain is combined. For early diagnosis and a better prognosis, patients should be promptly investigated with ultrasonography or computerized tomography.