Ostre ogniskowe bakteryjne zapalenie nerek u dzieci (AFBN) jako proces wyprzedzajÄ cy tworzenie się ropni nerek

AFBN is a rarely reported pattern of kidney parenchyma bacterial infection with tendency to form local abscesses. The local infection develops within the bloodstream - transmitted material is coming from distant foci or is the result of ascending urinary tract infection, mainly in cases of congenital lower urinary tract defects. Clinical pattern is dominated by the presence of high fever, non-specific abdominal pain and high values of inflammatory markers. Renal ultrasound (USG) and renal CT scan are used as supportive diagnostic tools. We present the results of clinical analysis of 14 cases diagnosed as AFBN. All 14 children presented high values of CRP, variable leukocyturia and infection with E.coli or Staph. epidermidis. The USG was not quite informative, while renal CT scan revealed extensive inflammatory infiltrates in kidney parenchyma with trend to form local abscesses. Long-term wide-range antibiotic therapy was used. This treatment stopped the abscess formation and made surgical management unnecessary. We observed that the incidence of AFBN increased in recent years and included predominantly the pubertal girls. Static renal scyntygraphy will be the diagnostic tool in long-term follow-up monitoring.