{"title":"Pediatric renal abscess: clinical analysis and literature review.","authors":"Jianxin Sun, Lina Shi, Lezhen Ye, Yanan Xu","doi":"10.3389/fped.2025.1407437","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pediatric renal abscesses is a severe infectious disease with a long treatment period. Due to atypical symptoms, there is a risk of delayed diagnosis, missed diagnosis, and misdiagnosis. Inadequate or incomplete treatment can lead to prolonged hospital stays, even Irreversible kidney damage. This study aimed to analyze the clinical characteristics of pediatric renal abscesses, aiming for early diagnosis and timely, appropriate treatment.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on clinical manifestations, laboratory tests, imaging studies, and treatment data of 12 pediatric renal abscess cases treated in the Nephrology Department of our hospital from October 2018 to March 2023.</p><p><strong>Results: </strong>Among the 12 cases, there were 3 males and 9 females, aged between 7 months to 12 years. All cases were from urban areas, with fever being the primary symptom (100%), accompanied in some by abdominal pain and urinary frequency/pain. Clinical symptoms were atypical, with 91% showing elevated white blood cell count(WBC), a significant rise in neutrophil percentage, C-reactive protein (CRP), and a marked increase in procalcitonin (100%). significant elevation of urinary white blood cells in 83.3% of cases. Both urine and blood cultures were negative. All 12 cases underwent abdominal CT or Magnetic Resonance Urography (MRU), showing abscesses, all less than 3 cm. Treatment included third-generation cephalosporins, with the addition of linezolid in cases where the initial treatment was ineffective. Hospital stays ranged from 10 to 21 days. Follow-up MRU showed the disappearance of abscesses.</p><p><strong>Conclusion: </strong>Clinical symptoms of pediatric renal abscesses are atypical. Children with fever, accompanied by abdominal pain, and significant elevation in white blood cells, CRP, and PCT should be considered for renal abscess, and abdominal CT or MRU is recommended for early diagnosis. Conservative anti-infection treatment can yield good results for abscesses smaller than 3 cm.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1407437"},"PeriodicalIF":2.1000,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066547/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fped.2025.1407437","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Pediatric renal abscesses is a severe infectious disease with a long treatment period. Due to atypical symptoms, there is a risk of delayed diagnosis, missed diagnosis, and misdiagnosis. Inadequate or incomplete treatment can lead to prolonged hospital stays, even Irreversible kidney damage. This study aimed to analyze the clinical characteristics of pediatric renal abscesses, aiming for early diagnosis and timely, appropriate treatment.
Methods: A retrospective analysis was conducted on clinical manifestations, laboratory tests, imaging studies, and treatment data of 12 pediatric renal abscess cases treated in the Nephrology Department of our hospital from October 2018 to March 2023.
Results: Among the 12 cases, there were 3 males and 9 females, aged between 7 months to 12 years. All cases were from urban areas, with fever being the primary symptom (100%), accompanied in some by abdominal pain and urinary frequency/pain. Clinical symptoms were atypical, with 91% showing elevated white blood cell count(WBC), a significant rise in neutrophil percentage, C-reactive protein (CRP), and a marked increase in procalcitonin (100%). significant elevation of urinary white blood cells in 83.3% of cases. Both urine and blood cultures were negative. All 12 cases underwent abdominal CT or Magnetic Resonance Urography (MRU), showing abscesses, all less than 3 cm. Treatment included third-generation cephalosporins, with the addition of linezolid in cases where the initial treatment was ineffective. Hospital stays ranged from 10 to 21 days. Follow-up MRU showed the disappearance of abscesses.
Conclusion: Clinical symptoms of pediatric renal abscesses are atypical. Children with fever, accompanied by abdominal pain, and significant elevation in white blood cells, CRP, and PCT should be considered for renal abscess, and abdominal CT or MRU is recommended for early diagnosis. Conservative anti-infection treatment can yield good results for abscesses smaller than 3 cm.
期刊介绍：
Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.
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